Johnson, Theodore Lawrence
Johnson, Theodore Lawrence is an individual health care provider with primary practice located at 200 E Roosevelt Rd , Lombard IL 60148-4539. He recently has only one registered license in Chiropractic Providers / Internist, which is considered as his primary health care specialty. Johnson, Theodore Lawrence can be contacted via phone (630) 889-6513.Contact Information
Primary practice address
200 E Roosevelt Rd
Lombard IL 60148-4539
Phone: (630) 889-6513
Fax: (630) 889-6800
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Internist | 111NI0900X | 0038006656 | Illinois |
Profile Details
| NPI number | 1194703751 |
|---|---|
| LBN Legal business name | Johnson, Theodore Lawrence |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Apr 29th, 2016 - about 8 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 | 1194703751 | NPPES |
| Illinois | Other | 0038006656 | PROFESSIONAL LICENCE NUMB |
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