Individual
REBECCA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 S SWEETBRIAR DR, CHILLICOTHE, IL 61523-2264
(309) 274-2102
(309) 274-3555
Mailing address
1092 UPPER SPRING BAY RD, EAST PEORIA, IL 61611-9648
(618) 401-8380
(309) 274-3555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004289
IL
Other
Enumeration date
03/27/2012
Last updated
07/02/2014
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