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NPI Code Detail

MEDICARE: ALSHILOH S JOHNSON

MEDICARE:   ALSHILOH S 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
1385HR2060XChild Intellectual and/or Developmental Disabilities Respite Care

General Provider Information

NPI Number : 1467228882
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALSHILOH S JOHNSON
Provider Business Mailing Address
First Line : 7645 S KINGSTON AVE # 2
Second Line :
City : CHICAGO
State : IL
Zip : 60649-6456
Country : US
Telephone Number : 773-990-9833
Fax Number :
Provider Business Practice Location Address
First Line : 7645 S KINGSTON AVE # 2
Second Line :
City : CHICAGO
State : IL
Zip : 60649-6456
Country : US
Telephone Number : 773-990-9833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2023
Last Update Date : 12/08/2023

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Directions to “ ALSHILOH S JOHNSON ” Practice Location

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