Individual
LORNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W TAYLOR ST., 764E UIH, MC 509, CHICAGO, IL 60605
(630) 408-6276
Mailing address
215 75TH ST, WILLOWBROOK, IL 60527-2388
(630) 408-6276
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016491
IL
363LA2200X
Adult Health Nurse Practitioner
209016491
IL
363LG0600X
Gerontology Nurse Practitioner
209016491
IL
363LP2300X
Primary Care Nurse Practitioner
209016491
IL
Other
Enumeration date
01/26/2018
Last updated
04/27/2018
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