Johansen, Mary Christine

Johansen, Mary Christine is an sole proprietor health care provider with primary practice located at 3880 Salem Lake Dr Ste F , Long Grove IL 60047-5292. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Johansen, Mary Christine can be contacted via phone (847) 719-2220.

Contact Information

Primary practice address
3880 Salem Lake Dr Ste F Long Grove IL 60047-5292
Phone: (847) 719-2220
Fax: (847) 719-2265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.020914 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209020614 Illinois

Profile Details

NPI number 1689208928
LBN Legal business name Johansen, Mary Christine
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 25th, 2020
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689208928 NPPES
Illinois MEDICAID 209020914

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