Johnson, Byron Melvin

Johnson, Byron Melvin is an individual health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Johnson, Byron Melvin can be contacted via phone (708) 216-9000.

Contact Information

Primary practice address
2160 S 1St Ave Maywood IL 60153-3328
Phone: (708) 216-9000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9343184 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209023906 Illinois

Profile Details

NPI number 1902296080
LBN Legal business name Johnson, Byron Melvin
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 28th, 2015
Last updated May 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902296080 NPPES
Florida MEDICAID 014279800

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