Johnson, Todd Andrew

Johnson, Todd Andrew is an individual health care provider with primary practice located at 1765 N Elston Ave Suite 110, Chicago IL 60642-1501. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Johnson, Todd Andrew can be contacted via phone (773) 276-1100.

Contact Information

Primary practice address
1765 N Elston Ave Suite 110 Chicago IL 60642-1501
Phone: (773) 276-1100
Fax: (773) 276-1102
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 036110291 Illinois
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036110291 Illinois

Profile Details

NPI number 1033208418
LBN Legal business name Johnson, Todd Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Nov 3rd, 2015 - about 11 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 1033208418 NPPES
Illinois MEDICAID 036110291

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