Johnson, Todd Andrew
Johnson, Todd Andrew is an individual health care provider with primary practice located at 1765 N Elston Ave Suite 110, Chicago IL 60642-1501. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Johnson, Todd Andrew can be contacted via phone (773) 276-1100.Contact Information
Primary practice address
1765 N Elston Ave Suite 110
Chicago IL 60642-1501
Phone: (773) 276-1100
Fax: (773) 276-1102
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 036110291 | Illinois |
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036110291 | Illinois |
Profile Details
NPI number | 1033208418 |
---|---|
LBN Legal business name | Johnson, Todd Andrew |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 12th, 2006 |
Last updated | Nov 3rd, 2015 - about 10 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 | 1033208418 | NPPES |
Illinois | MEDICAID | 036110291 |
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