Johnson, Lawrence L
Johnson, Lawrence L is an sole proprietor health care provider with primary practice located at 3310 W. Main Street Suite 115, St. Charles IL 60175. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Johnson, Lawrence L can be contacted via phone (630) 232-2885.Contact Information
Primary practice address
3310 W. Main Street Suite 115
St. Charles IL 60175
Phone: (630) 232-2885
Fax: (630) 232-9936
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036 052717 | Illinois |
Profile Details
| NPI number | 1114015351 |
|---|---|
| LBN Legal business name | Johnson, Lawrence L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Mar 31st, 2017 - about 7 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 | 1114015351 | NPPES |
| Illinois | Other | 0004500588 | BLUE CROSS BLUE SHIELD ID |
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