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1649531542
KENNETH ROBERT JOHNSON
CHICAGO, IL
NPI
1649531542
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: IL 180.010434)
Enumeration Date
2012-06-06
Last Update Date
2016-09-14
Business Address
Mr. KENNETH ROBERT JOHNSON L.C.P.C.
5710 N BROADWAY ST
CHICAGO, IL 60660-4302
Phone number: 872-235-0626
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Mailing Address
Mr. KENNETH ROBERT JOHNSON L.C.P.C.
5710 N BROADWAY ST
CHICAGO, IL 60660-4302
Phone number: 872-235-0626
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