Individual
BILL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1712 W ESTES AVENUE UNIT 109, CHICAGO, IL 60626
(872) 205-0665
Mailing address
1712 W ESTES AVE APT 109, CHICAGO, IL 60626-2402
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009578
IL
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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