Provider Demographics
NPI:1861533424
Name:JOHNSON, KAREN ELAINE (DC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELAINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-2229
Mailing Address - Country:US
Mailing Address - Phone:630-649-4853
Mailing Address - Fax:
Practice Address - Street 1:0S165 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1245
Practice Address - Country:US
Practice Address - Phone:630-649-4853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor