MEDICARE: KARLA DORSEY-JOHNSON MD

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
1	207Q00000X	Family Medicine Physician	036108642	IL

General Provider Information

NPI Number	:	1245205731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA DORSEY-JOHNSON MD

Provider Business Mailing Address
First Line	:	1860 PAYSPHERE CIR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-0018
Country	:	US
Telephone Number	:	630-469-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 S WASHINGTON ST
Second Line	:	STE 350
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6603
Country	:	US
Telephone Number	:	630-717-2646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	07/21/2022

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