MR. WENDELL WALTER JOHNSON (NPI# 1558449876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558449876 |
| Entity Type | Individual |
| Full Name | MR. WENDELL WALTER JOHNSON |
| Practice Address |
4735 N Beacon #109 Chicago IL 60640 |
| Mailing Address |
12626 S Elizabeth St Calumet Park IL 60827-6111 |
| Practice Telephone | 7732934575 |
| Mailing Telephone | 7083968923 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730475914 | Wendell Sebastian Johnson | Student in an Organized Health Care Education/Training Program | 47 Charles St, South River, NJ 08882-1605 | 2011-06-25 |
| 1013024181 | Wendell Johnson | Anesthesiology | 7703 Floyd Curl Dr, Mc 7977, San Antonio, TX 78229 | 2006-08-24 |
| 1083654065 | Wendell C Johnson | Radiology | 5444 S. Green St., Murray, UT 84123-5632 | 2006-06-07 |
| Street Address |
4735 N BEACON #109 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346899630 | Jeremy Gantz Morse | Specialist | 815 W Buena Ave, Chicago, IL 60613-1694 | 2019-09-09 |
| 1619539632 | Benjamin Mendoza | Specialist | 6303 W 63rd St Unit 3c, Chicago, IL 60638-7015 | 2019-06-29 |
| 1811471808 | Judith M Penn | Specialist | 8312 S Kedzie Ave, Chicago, IL 60652-3309 | 2018-09-17 |
| 1841774825 | Matthew E Huggins | Specialist | 4553 W 56th St Apt 204c, Chicago, IL 60629-5389 | 2018-09-17 |
| 1750860177 | Muhammad Asim Khan | Specialist | 60 E Delaware Pl, Chicago, Il 60611, 14th Floor Urology- Andrology Clinic, Chicago, IL 60611 | 2018-08-07 |
| 1922502657 | Shauntay Robertson | Specialist | 7342 S Richmond St, Chicago, IL 60629-3015 | 2018-03-19 |
| 1114448644 | Ageless Men's Health Holdings Inc | Specialist | 1729 N Clybourn Ave, Chicago, IL 60614-6503 | 2017-07-06 |
| 1447798871 | Andria Miller | Specialist | 840 N Western Ave, Chicago, IL 60622-4638 | 2017-02-06 |
| 1710425129 | Rtb Sc | Specialist | 5015 N. Paulina #225, Chicago, IL 60640 | 2017-02-06 |
| 1881137354 | Joy Deliverance Williamson | Specialist | 3863 W Flournoy St, Apt. 1w, Chicago, IL 60624-3617 | 2016-11-30 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on MR. WENDELL WALTER JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.