| Doctor Name: | MS. ANDRENE RENEE JOHNSON |
| NPI Number: | 1093940363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3224 S Western Ave Park Forest, IL - 60466 |
| Business Phone Number: | 3122594200 |
| Business Fax Number: | |
| Mailing Address: | 1803 W. 95th St., Unit 196 CHICAGO |
| State: | IL |
| Postal Code: | 606431103 |
| Phone Number: | 3122594200 |
| Fax Number: | 7732980673 |
| NPI Enumeration Date: | 05/15/2009 |
| NPI Last Update Date: | 05/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |