IndividualActive
David Johnsen, NAVY IDC
NPI 1467420422 · Independent Duty Corpsman · Great Lakes, IL
Provider details
- NPI number
- 1467420422
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- NAVY IDC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
3001a Sixth Street
Naval Hospital Fisher Clinic
Great Lakes, IL 60088
Phone: (847) 688-2469
Fax: (847) 688-2512
Approximate (ZIP-level) locationGet directions
Mailing address
1130 Bob Ofarrell Ln
Beach Park, IL 60099-4512
Registry dates
- Enumerated
- 2006-03-08
- Last updated
- 2008-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.