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1316553472
NICHOLAS JOHNSON
CHICAGO, IL
NPI
1316553472
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: IL 209021402)
Enumeration Date
2020-09-23
Last Update Date
2020-09-23
Business Address
NICHOLAS JOHNSON APN
8455 S LUELLA AVE
CHICAGO, IL 60617-1953
Phone number: 773-727-5355
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Mailing Address
NICHOLAS JOHNSON APN
8455 S LUELLA AVE
CHICAGO, IL 60617-1953
Phone number: 773-727-5355
Copy
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