Healthcare Provider Details

I. General information

NPI: 1578468740
Provider Name (Legal Business Name): LONYAE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 WESTBURY LN
AURORA IL
60502-7178
US

IV. Provider business mailing address

1525 N LOREL AVE
CHICAGO IL
60651-1318
US

V. Phone/Fax

Practice location:
  • Phone: 773-331-7616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: