Most Relevant Information
Provider Data
| NPI Number: | 1003221680 |
| Provider Name: | KEVIN DARNELL JOHNSON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 125065696 |
Most Important Dates
| Enumeration Date: | 06/23/2014 |
| Last Updated: | 06/23/2014 |
Provider Practice Location
5101 WILLOW SPRINGS RD
2ND FLOOR
LA GRANGE
IL
605252600
Practice Location Phone/Fax
| Phone: | 7082458900 |
| Fax: | 7082455604 |
Provider Mailing Location
5101 WILLOW SPRINGS RD
2ND FLOOR
LA GRANGE
IL
605252600
Provider Mailing Phone/Fax
| Phone: | 7082458900 |
| Fax: | 7082455604 |