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Individual

JENNIFER C JOHANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1725 W HARRISON ST, SUITE 1118, CHICAGO, IL 60612-3841
(312) 942-5936
Mailing address
1725 W HARRISON ST, SUITE 1118, CHICAGO, IL 60612-3841
(312) 942-5936

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-007606
IL

Other

Enumeration date
06/25/2009
Last updated
06/25/2009
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