Johnson, Lawrence L

Johnson, Lawrence L is an sole proprietor health care provider with primary practice located at 3310 W. Main Street Suite 115, St. Charles IL 60175. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Johnson, Lawrence L can be contacted via phone (630) 232-2885.

Contact Information

Primary practice address
3310 W. Main Street Suite 115 St. Charles IL 60175
Phone: (630) 232-2885
Fax: (630) 232-9936
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036 052717 Illinois

Profile Details

NPI number 1114015351
LBN Legal business name Johnson, Lawrence L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Mar 31st, 2017 - about 9 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 1114015351 NPPES
Illinois Other 0004500588 BLUE CROSS BLUE SHIELD ID

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