MEDICARE: RHONDA JOHNSON LCMT

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	225700000X	Massage Therapist	227020616	IL
2	3747A0650X	Attendant Care Provider	NONE	IL

General Provider Information

NPI Number	:	1609429968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA JOHNSON LCMT

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR # 1102547
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4546
Country	:	US
Telephone Number	:	773-577-3279
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR # 1102547
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4546
Country	:	US
Telephone Number	:	773-577-3279
Fax Number	:

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

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	04/22/2026

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Directions to “ RHONDA JOHNSON LCMT” Practice Location

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