NPI 1225969892

Matthew Russell Johnsom, EMT

Practitioner Basic Emergency Medical Technician Loves Park, IL

Practice location

Address: 12318 Empire St, Loves Park, IL 61111-8957
Phone: (815) 378-4556

Registered specialties

Basic Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146N00000X

Other Emergency Medical Technician, Basic providers in Illinois →

Registry record

NPI: 1225969892
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 May 2026
Record last updated: 25 May 2026

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.