Andrene Renee Johnson

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

3224 S Western Ave
Park Forest, IL 60466

Phone

(312) 259-4200

NPI assigned

May 15, 2009

Last updated

May 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Andrene Renee Traylor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1093940363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W. 95TH ST.",
            "address_2": "UNIT 196",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431103",
            "telephone_number": "312-259-4200",
            "fax_number": "773-298-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 S WESTERN AVE",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "60466",
            "telephone_number": "312-259-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDRENE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDRENE",
            "last_name": "TRAYLOR",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Darlene Jefferson
• Jelani Helathcare and Family Services
• Demitris Johnson
• Frankie Johnson
• Iesha J Johnson
• Marie Johnson
• Matthew Todd Johnson, MD

• Durable Medical Equipment & Medical Supplies in Park Forest, IL
• Providers in Park Forest, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.