NPI 1003221680

Kevin Darnell Johnson, MD

Practitioner Student in an Organized Health Care Education/Training Program La Grange, IL

Practice location

Address: 5101 Willow Springs Rd 2nd Floor, La Grange, IL 60525-2600
Phone: (708) 245-8900
Fax: (708) 245-5604

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X Licence 125065696 (IL)

Other Student in an Organized Health Care Education/Training Program providers in Illinois →

Registry record

NPI: 1003221680
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2014
Record last updated: 23 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.