Dr Ryan Michael Johnson, DO | |
1300 Franklin Ave Ste 110, Normal, IL 61761-3799 | |
(309) 268-3502 | |
Not Available |
Full Name | Dr Ryan Michael Johnson |
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Gender | Male |
Speciality | Neurological Surgery |
Location | 1300 Franklin Ave Ste 110, Normal, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1932559119 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207T00000X | Neurological Surgery | 125069500 (Illinois) | Primary |
Entity Name | Carle Health Care Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
Entity Name | Carle West Physician Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
Mailing Address | Practice Location Address |
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Dr Ryan Michael Johnson, DO 2000 N Linden St Apt C305, Normal, IL 61761-5337 Ph: (740) 632-3117 | Dr Ryan Michael Johnson, DO 1300 Franklin Ave Ste 110, Normal, IL 61761-3799 Ph: (309) 268-3502 |
Paul Jene Gustin, DO Neurological Surgery Medicare: Medicare Enrolled Practice Location: 1300 Franklin Ave, Normal, IL 61761 Phone: 309-268-3502 | |
Dr. Gina Nicole Guglielmi, DO Neurological Surgery Medicare: Medicare Enrolled Practice Location: 1302 Franklin Ave Ste 2800, Normal, IL 61761 Phone: 309-268-6300 | |
Dr. Joshua Sterling Bentley, D.O. Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 1304 Franklin Ave, Normal, IL 61761 Phone: 309-268-3713 |