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ANNIE JOHN M.D.S.C. NPI 1114909363


NPI Information

NPI: 1114909363
Provider Name: ANNIE JOHN, M.D.S.C.
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
3434 W PETERSON AVE
1A
CHICAGO, IL
ZIP 60659
Phone: (773) 583-5803
Get Directions

ANNIE JOHN, M.D.S.C. is a geriatric medicine internal medicine in Chicago, IL. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. ANNIE JOHN, M.D.S.C. NPI is 1114909363. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3434 W PETERSON AVE
1A
CHICAGO, IL
ZIP 60659-319
Phone: (773) 583-5803

The provider's authorized official is Annie John .
The authorized official title is President and has the following contact phone number (773) 989-3977.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 9/14/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1164W00000XLicensed Practical Nurse209-003580ILLINOISNo
2207RG0300XInternal MedicineGeriatric Medicine036-068169ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1208848MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2036068169MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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