MEDICARE: DR. PATRICK R. JOHNSTON D. C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038-005305	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016-82737	OTHER	IL	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1265507339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK R. JOHNSTON D. C.

Provider Business Mailing Address
First Line	:	117 E PALATINE RD STE 109
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5129
Country	:	US
Telephone Number	:	847-208-4838
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 E PALATINE RD STE 109
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5129
Country	:	US
Telephone Number	:	847-208-4838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	01/10/2026

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