Search › Illinois › 208D00000X
Theodore Johnson, MD
NPI 1609523240 · on the registry since 2022
Practice
- Address
- 3410 Illinois St
Great Lakes, IL 60088 - Phone
- (224) 610-8553
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 208D00000X
208D00000X
- Also registered as
- 171000000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-07-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois