| NPI | 1407000177 |
|---|---|
| Doing Business As | PRIVATE PRACTICE OF RIVER FOREST |
| Entity Type | Organization |
| Authorized Contact | CHARLES B JOHNSTON President 708-681-7905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036078749) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036078749) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2008-11-07 |