Doctor Name: | JEFFREY B JOHNSON |
NPI Number: | 1164564019 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 36042236 |
Business Practice Address: | 1555 N Barrington Road #410 Hoffman Estates, IL - 60195 |
Business Phone Number: | 8478820975 |
Business Fax Number: | 8478821072 |
Mailing Address: | 1555 N Bartington Road #410, HOFFMAN ESTATES |
State: | IL |
Postal Code: | 60169 |
Phone Number: | 8478820975 |
Fax Number: | 8478821072 |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 10/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 36042236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |