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NPI Code Detail

MEDICARE: MORGAN ANN JOHANNES

MEDICARE: MORGAN ANN JOHANNES
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
1363A00000XPhysician Assistant1982336590IL

General Provider Information

NPI Number : 1982336590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN ANN JOHANNES
Provider Business Mailing Address
First Line : 5311 S HARLEM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-1006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5311 S HARLEM AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-1006
Country : US
Telephone Number : 773-992-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2022
Last Update Date : 12/18/2023

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Directions to “ MORGAN ANN JOHANNES ” Practice Location

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