| Doctor Name: | MS. DEA MARIE JOHNSON |
| NPI Number: | 1194838664 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CADC, SAP |
| License Number: | 18153 |
| Business Practice Address: | 2 Mid America Plz Suite 800 Oakbrook Terrace, IL - 601814451 |
| Business Phone Number: | 6306757686 |
| Business Fax Number: | 6306910901 |
| Mailing Address: | 2 Mid America Plz, Suite 800 OAKBROOK TERRACE |
| State: | IL |
| Postal Code: | 601814451 |
| Phone Number: | 6306757686 |
| Fax Number: | 6306910901 |
| NPI Enumeration Date: | 08/17/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 18153 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |