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NPI Code Detail

MEDICARE: ALINE GILBERT-JOHNSON MD

MEDICARE: ALINE GILBERT-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
12084P0800XPsychiatry Physician036110211IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2640701OTHERILMEDICARE WPS FFS GROUP
3CF3444OTHERILMEDICARE RAILROAD GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770521148
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALINE GILBERT-JOHNSON MD
Provider Business Mailing Address
First Line : PO BOX 577
Second Line :
City : CARTERVILLE
State : IL
Zip : 62918-0577
Country : US
Telephone Number : 618-985-8221
Fax Number : 618-985-6860
Provider Business Practice Location Address
First Line : 3111 WILLIAMSON COUNTY PKWY
Second Line :
City : MARION
State : IL
Zip : 62959-5235
Country : US
Telephone Number : 618-997-3647
Fax Number : 618-998-1328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 07/29/2010

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Directions to “ ALINE GILBERT-JOHNSON MD” Practice Location

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