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NPI 1114015351

IndividualActive

Lawrence Johnson, M.D.

NPI 1114015351 · Dermatology Physician · St. Charles, IL

Provider details

NPI number: 1114015351
Entity type: Individual
Primary specialty: Dermatology PhysicianAllopathic & Osteopathic Physicians
Credential: M.D.
Sex: Male
Sole proprietor: Yes
License: 036 052717 (IL)

Practice location

3310 W. Main Street

Suite 115

St. Charles, IL 60175

Phone: (630) 232-2885

Fax: (630) 232-9936

More IL providers

Mailing address

3310 W. Main Street

St. Charles, IL 60175

Registry dates

Enumerated: 2006-10-11
Last updated: 2017-03-31

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Lawrence Johnson, M.D. — NPI 1114015351, St. Charles, IL | NPI Central