Individual
JOSHUA ALLEN JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-3886
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006596
IL
Other
Enumeration date
11/23/2016
Last updated
10/08/2025
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