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NPI Code Detail

MEDICARE: MRS. MEGAN ROSE JOHNSON M.S.

MEDICARE: MRS. MEGAN ROSE JOHNSON M.S.
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
1101YP2500XProfessional Counselor180.009490IL

General Provider Information

NPI Number : 1932538261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN ROSE JOHNSON M.S.
Provider Business Mailing Address
First Line : 9697 191ST ST
Second Line :
City : MOKENA
State : IL
Zip : 60448-8609
Country : US
Telephone Number : 630-646-6495
Fax Number :
Provider Business Practice Location Address
First Line : 9697 191ST ST
Second Line :
City : MOKENA
State : IL
Zip : 60448-8609
Country : US
Telephone Number : 630-646-6495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2013
Last Update Date : 12/28/2023

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