Stacie L Johnson PAC

NPI 1770696890 - Physician Assistant - 363A00000X

NPI Details
NPI 1770696890
Gender Female
Enumeration Date 08/15/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
4201 W MEDICAL CENTER DR
MCHENRY IL, 60050-8409, US
Phone (815) 759-3100
Fax (815) 363-9044
Business Location
241 PENNY LN
LAKE GENEVA WI, 53147-2467, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State
License Number
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According to our database, Stacie L Johnson PAC NPI is 1770696890, taxonomy code is 363A00000X Stacie L Johnson PAC physically located at 4201 W Medical Center Dr, Mchenry IL, 60050-8409. NPI Number Stacie L Johnson PAC has the Individual type.

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1770696890 NPI number is provided on an as is basis without warranty of any kind. 1770696890 is maintained by the National Plan & Provider Enumeration System. The contents of Stacie L Johnson PAC are for informational purposes only.