MEDICARE: MR. WENDELL WALTER JOHNSON

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	174400000X	Specialist

General Provider Information

NPI Number	:	1558449876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WENDELL WALTER JOHNSON

Provider Business Mailing Address
First Line	:	12626 S ELIZABETH ST
Second Line	:
City	:	CALUMET PARK
State	:	IL
Zip	:	60827-6111
Country	:	US
Telephone Number	:	708-396-8923
Fax Number	:

Provider Business Practice Location Address
First Line	:	4735 N BEACON
Second Line	:	#109
City	:	CHICAGO
State	:	IL
Zip	:	60640
Country	:	US
Telephone Number	:	773-293-4575
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1891639787 — KATHERINE RACK WELLNESS PLLC
Practice Location Address:

5030 N WINTHROP AVE APT 3E
CHICAGO, IL
60640-6436

Practice Phone: 312-426-8731
Practice Fax:

1588163653 — THREE TALES THERAPY, LLC
Practice Location Address:

4809 N RAVENSWOOD AVE STE 424
CHICAGO, IL
60640-4495

Practice Phone: 773-599-1609
Practice Fax:

1861337347 — HANNAH ROSENBLATT PLLC
Practice Location Address:

4801 N RAVENSWOOD AVE # 9
CHICAGO, IL
60640-4478

Practice Phone: 203-641-4299
Practice Fax:

1508417056 — HANNAH GRACE ROSENBLATT LCSW
Practice Location Address:

4801 N RAVENSWOOD AVE # 9
CHICAGO, IL
60640-4478

Practice Phone: 203-641-4299
Practice Fax:

1265377667 — CATHERINE LEE
Practice Location Address:

5438 N PAULINA ST
CHICAGO, IL
60640-1128

Practice Phone: 202-251-3009
Practice Fax:

1790620151 — CHERYL H MCNALLY NCSP, I/ECMHC
Practice Location Address:

4611 N RAVENSWOOD AVE STE 105
CHICAGO, IL
60640-7569

Practice Phone: 312-899-6226
Practice Fax:

1306781505 — HEALTHSTED
Practice Location Address:

4541 N SHERIDAN RD APT 712
CHICAGO, IL
60640-6903

Practice Phone: 773-225-9460
Practice Fax:

Directions to “ MR. WENDELL WALTER JOHNSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.