| Doctor Name: | DR. JEFFREY T JOHNSON |
| NPI Number: | 1689786352 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 036050297 |
| Business Practice Address: | 0n150 Winfield Road Winfield, IL - 60190 |
| Business Phone Number: | 6306651550 |
| Business Fax Number: | 6306653510 |
| Mailing Address: | 0n150 Winfield Road, WINFIELD |
| State: | IL |
| Postal Code: | 60190 |
| Phone Number: | 6306651550 |
| Fax Number: | 6306653510 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 06/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036050297 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |