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Contact Information

CARL W JOHNSON II, MD
6703 W 159TH STREET
SUITE 110
TINLEY PARK, IL60477
 Phone: 708-331-1122
 Fax: 708-331-5987
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CARL W JOHNSON II · (Male)

NPI # 1467450122
Status Active
Credentials MD
Entity Individual
Enumeration date 07/07/2005
Last updated 09/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 36107266
  • IL Medicaid 36107266
  • IL Other 363950/L93169 MEDICARE GROUP/PROVIDER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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