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General NPI Number Information
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NPI Number | 1972013191
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Entity Type | Individual
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Provider Name | MONISHA JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 2030 SOUTH STATE ST APT 1104
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City | CHICAGO
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State | IL
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Zip | 60616
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Country | US
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Telephone | 773-245-6785
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 S MANISTEE AVE
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City | CHICAGO
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State | IL
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Zip | 60617-2048
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Country | US
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Telephone | 312-719-6664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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