Provider Demographics
NPI:1881109601
Name:JOHNSTON, LAUREN KAYE (DPT, PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KAYE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:7865 E BROADWAY BLVD STE 165
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3975
Practice Address - Country:US
Practice Address - Phone:520-407-6037
Practice Address - Fax:520-332-1299
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31260225100000X
NCP17574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist