| Doctor Name: | MR. PETER J. JOHNSON |
| NPI Number: | 1053517151 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MDR5274 |
| Business Practice Address: | 1555 N. Barrington Rd. Dob I, Suite 410 Hoffman, IL - 60169 |
| Business Phone Number: | 8477811894 |
| Business Fax Number: | 8477811895 |
| Mailing Address: | 1555 N. Barrington Rd., Dob I, Suite 410 HOFFMAN |
| State: | IL |
| Postal Code: | 60169 |
| Phone Number: | 8477811894 |
| Fax Number: | 8477811895 |
| NPI Enumeration Date: | 06/25/2007 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | MDR5274 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |