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Individual

CYNTHIA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10625 S MICHIGAN AVE, CHICAGO, IL 60628-2707
(773) 928-1109
(773) 928-2099
Mailing address
10625 S MICHIGAN AVE, CHICAGO, IL 60628-2707
(773) 928-1109
(773) 928-2099

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
251C00000X
Developmentally Disabled Services Day Training Agency
343900000X
Non-emergency Medical Transport (VAN)
Primary
J52510455820
IL

Other

Enumeration date
03/03/2009
Last updated
03/10/2009
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