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NPI Code Detail

MEDICARE: AMY SUE JOHNSON

MEDICARE: AMY SUE 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
1222Q00000XDevelopmental TherapistIL

General Provider Information

NPI Number : 1023980158
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SUE JOHNSON
Provider Business Mailing Address
First Line : 318 E ALMOND DR
Second Line :
City : WASHINGTON
State : IL
Zip : 61571-3104
Country : US
Telephone Number : 309-423-6243
Fax Number :
Provider Business Practice Location Address
First Line : 2635 NEWPORT DR
Second Line :
City : NAPERVILLE
State : IL
Zip : 60565-4339
Country : US
Telephone Number : 309-531-6504
Fax Number : 309-273-1385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2025
Last Update Date : 09/18/2025

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Directions to “ AMY SUE JOHNSON ” Practice Location

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