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General NPI Number Information
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NPI Number | 1992203798
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Entity Type | Individual
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Provider Name | LORNA JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST., 764E UIH, MC 509
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City | CHICAGO
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State | IL
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Zip | 60605
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Country | US
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Telephone | 630-408-6276
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Fax |
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Provider Business Mailing Address
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Address Line | 215 75TH ST
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City | WILLOWBROOK
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State | IL
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Zip | 60527-2388
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Country | US
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Telephone | 630-408-6276
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209016491
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209016491
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209016491
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209016491
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License Number State | IL
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