Victoria Lyn Johnson, CST/CSFA

Individual provider Active NPI Surgical Assistant · Minooka, IL

NPI 1285229302 · NPPES record last updated Mar 2, 2021

Key facts

NPI
1285229302
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
Practice address
401 O Toole Dr
Minooka, IL 60447-9496
Phone
(708) 937-8337
NPI assigned
Mar 2, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Yes

Addresses

Primary practice location

401 O Toole Dr
Minooka, IL 60447-9496

Mailing address

401 O Toole Dr
Minooka, IL 60447-9496
Phone (708) 937-8337

Other names

  • Victoria Lyn Carter Former name

Other providers in Minooka, IL

All providers in Minooka, IL · Surgical Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.