Johnson, Kathleen
Johnson, Kathleen is an individual health care provider with primary practice located at 5409 N Knoxville Ave , Peoria IL 61615. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Johnson, Kathleen can be contacted via phone (309) 682-7750.Contact Information
Primary practice address
5409 N Knoxville Ave
Peoria IL 61615
Phone: (309) 682-7750
Fax: (309) 682-7786
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | Illinois |
Profile Details
| NPI number | 1831177559 |
|---|---|
| LBN Legal business name | Johnson, Kathleen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831177559 | NPPES |
| Illinois | Other | IL0100 | JOHN DEERE |
| Illinois | Other | 1431758 | JOHN DEERE |
| Illinois | Other | 239090 | JOHN DEERE |
| Illinois | Other | 058975 | JOHN DEERE |
| Illinois | Other | 0007222342 | JOHN DEERE |
| Illinois | MEDICAID | 036065748-1 | JOHN DEERE |
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