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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
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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