DR. LAWRENCE L JOHNSON (NPI# 1114015351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114015351 |
| Entity Type | Individual |
| Full Name | DR. LAWRENCE L JOHNSON |
| Credential | M.D. |
| Practice Address |
3310 W. Main Street Suite 115 St. Charles IL 60175 |
| Practice Telephone | 6302322885 |
| Practice Fax Number | 6302329936 |
| Mailing Telephone | 6302322885 |
| Mailing Fax Number | 6302329936 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2017-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036 052717 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD ID | 0004500588 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477682086 | Lawrence A Johnson | Dentist | 1850 W Pointe Dr, Oshkosh, WI 54902-4164 | 2007-03-02 |
| 1568511863 | Lawrence A Johnson | Chiropractor | 90 Jericho Tpke, Suite 6, Mineola, NY 11501-1845 | 2007-01-09 |
| 1881616241 | Lawrence Revel Johnson | Pathology | Icon Plc, 123 Smith St., Farmingdale, NY 11735 | 2006-07-24 |
| 1861410367 | Lawrence Joseph Johnson | Psychologist | 4149 N Holland Sylvania Rd, Suite 6, Toledo, OH 43623-4808 | 2006-07-17 |
| 1710482005 | Lawrence Brian Johnson | Counselor | 216 W Los Angeles Dr, Vista, CA 92083-3101 | 2018-03-28 |
| 1144400052 | Lawrence Vincent Johnson Jr. | Pharmacist | 225 Meadowbrook Rd, Jackson, MS 39206-5252 | 2007-11-08 |
| 1306992714 | Lawrence Bernard Johnson | Pediatrics | 3319 W Belvedere Ave, Baltimore, MD 21215-5103 | 2007-01-26 |
| 1174550644 | Lawrence F Johnson | Internal Medicine | 619 19th Street South, Birmingham, AL 35233 | 2006-06-28 |
| 1225003049 | Lawrence P Johnson | Orthopaedic Surgery | 10 Research Pl, Suite 203, North Chelmsford, MA 01863-2439 | 2006-02-23 |
| 1619968641 | Lawrence Webster Johnson | Internal Medicine | 2400 Hospital Dr Ste 370, Bossier City, LA 71111-2391 | 2005-10-31 |
| Street Address |
3310 W. MAIN STREET SUITE 115 |
| City | ST. CHARLES |
| State | IL |
| Zip Code | 60175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407005218 | Evan Dean Johnson | Dermatology | 3310 W. Main Street, Suite 115, St. Charles, IL 60175-4220 | 2008-09-17 |
| 1194937169 | Withman H Haro | Pediatrics | 3310 W. Main Street, Suite 200, St. Charles, IL 60175 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740733138 | Ryan Paul Kuebler | Dentist | 40w320 La Fox Rd., Suite D, St Charles, IL 60175 | 2016-08-02 |
| 1346602554 | Erica Witkowski | Specialist/Technologist | 6n 370 Crescent Lane, Saint Charles, IL 60175 | 2016-03-26 |
| 1437495728 | Bradley S Murison | Physical Therapist | 3381 W State St., Suite 100, St Charles, IL 60175 | 2012-12-14 |
| 1942507355 | Fox River & Countryside Fire/rescue District | Ambulance | 35w350 Carl Lee Road, St Charles, IL 60175 | 2011-02-21 |
| 1871825984 | Fay E Jackson | Counselor | 3140 W Route 64, St. Charles, IL 60175 | 2010-02-01 |
| 1801126941 | Philip James Kocisko | Counselor | 3140 W. Route 64, Saint Charles, IL 60175 | 2010-01-13 |
| 1891971529 | Caroline M Bollentino | Speech-Language Pathologist | 40w310 La Fox Rd, Suite A1-b1, St Charles, IL 60175 | 2008-01-11 |
| 1770783599 | Joy O Urubusi | Psychiatry & Neurology | 3825 Campton Hills Road, St Charles, IL 60175 | 2007-07-19 |
| 1225236052 | Anna Almase Medina | Dentist | 2445 Dean, 1c, St Charles, IL 60175 | 2007-07-03 |
| 1467666453 | Shelly Sinatra | Nurse Practitioner | 3310 W. Main St, Suite 200, St. Charles, IL 60175 | 2007-05-09 |
| Find all providers in zip 60175 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942481940 | Mona Yogesh Gandhi | Dermatology | 2900 Foxfield Rd Ste 200, St. Charles, IL 60174 | 2007-11-18 |
| 1407005218 | Evan Dean Johnson | Dermatology | 3310 W. Main Street, Suite 115, St. Charles, IL 60175-4220 | 2008-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1063030252 | Vitalskin Medical Group Il Pllc | Dermatology | 1111 W Kenyon Rd, Urbana, IL 61801-1010 | 2020-07-14 |
| 1447873831 | Derick Dermatology, LLC | Dermatology | 5250 Old Orchard Rd Ste 110, Skokie, IL 60077-4461 | 2020-05-20 |
| 1346869393 | Julia Katsnelson Md Sc | Dermatology | 231 Olde Half Day Rd, Lincolnshire, IL 60069-2906 | 2020-04-10 |
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1013559400 | Orsini Surgical Dermatology Sc | Dermatology | 1519 Legacy Cir, Naperville, IL 60563-3161 | 2019-10-17 |
| 1124675244 | Kiracofe Md Medical, LLC | Dermatology | 719 South Blvd # 2903, Oak Park, IL 60302-2903 | 2019-08-22 |
| 1366009664 | Derick Dermatology | Dermatology | 1900 Spring Rd Ste 210, Oak Brook, IL 60523-9063 | 2019-05-22 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | ST. CHARLES |
| Zip Code | 60175 |
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| 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.