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NPI Code Detail

MEDICARE: MRS. MARIA A JOHNSON MS CCCSLP

MEDICARE:  MRS. MARIA A JOHNSON  MS CCCSLP
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
1235Z00000XSpeech-Language Pathologist146008532IL

General Provider Information

NPI Number : 1720154628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIA A JOHNSON MS CCCSLP
Provider Business Mailing Address
First Line : 624 BEDFORD DR
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-8402
Country : US
Telephone Number : 847-293-1421
Fax Number :
Provider Business Practice Location Address
First Line : 1620 N LASALLE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-6005
Country : US
Telephone Number : 312-943-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 04/28/2025

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Directions to “ MRS. MARIA A JOHNSON MS CCCSLP” Practice Location

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