Most Relevant Information
Provider Data
| NPI Number: | 1003518341 |
| Provider Name: | SAMUEL JOHNSON DO |
| Entity Type: | Individual |
| Taxonomy Code: | 207L00000X |
| Specialty: | Anesthesiology |
| License Number: | 125.083250 |
Most Important Dates
| Enumeration Date: | 03/20/2023 |
| Last Updated: | 06/19/2024 |
Provider Practice Location
600 S PAULINA ST STE 403
CHICAGO
IL
606123806
Practice Location Phone/Fax
| Phone: | 3129423134 |
| Fax: | 5013802282 |
Provider Mailing Location
600 S PAULINA ST STE 403
CHICAGO
IL
606123806
Provider Mailing Phone/Fax
| Phone: | 3129423134 |
| Fax: | 5013802282 |