| Doctor Name: | JOSHUA R JOHNSON |
| NPI Number: | 1376840421 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 085003901 |
| Business Practice Address: | 400 S. Kennedy Bradley, IL - 60915 |
| Business Phone Number: | 8159288050 |
| Business Fax Number: | 8005052218 |
| Mailing Address: | 400 S Kennedy Dr, BRADLEY |
| State: | IL |
| Postal Code: | 609152682 |
| Phone Number: | 8159288050 |
| Fax Number: | 8005052218 |
| NPI Enumeration Date: | 02/24/2011 |
| NPI Last Update Date: | 02/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085003901 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |