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1154903920
DERICK JOHNSON
CHICAGO, IL
NPI
1154903920
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL 209.022844)
Enumeration Date
2021-04-22
Last Update Date
2021-04-22
Business Address
Mr. DERICK JOHNSON APRN
9900 S PERRY AVE
CHICAGO, IL 60628-1348
Phone number: 312-545-3187
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Mailing Address
Mr. DERICK JOHNSON APRN
9900 S PERRY AVE
CHICAGO, IL 60628-1348
Phone number: 312-545-3187
Copy
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