Organization Active NPI

Donna L Johnson MD SC

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1538342134
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036055866 Issued in IL
Legal business name
DONNA L JOHNSON MD SC
Practice address
7257 S Jeffery Blvd
Chicago, IL 60649-3014
Phone
(773) 493-7040
Fax
(773) 493-8837
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Dr. Donna Johnson, MD
Title
Physician
Phone
(773) 493-7041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 036055866 IL Primary

Addresses

Primary practice location

7257 S Jeffery Blvd
Chicago, IL 60649-3014

Mailing address

7257 S Jeffery Blvd
Chicago, IL 60649-3014
Phone (773) 493-7040

Other identifiers 3

IdentifierTypeStateIssuer
180030052OtherILRAILROAD MEDICARE
036055856MedicaidIL
21608627OtherILBCBS

National Provider Directory

National Provider Directory

Locations

30 N Michigan Ave
Ste 122526
Chicago, IL 60602
Phone (312) 853-3305

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1538342134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7257 S JEFFERY BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493014",
            "telephone_number": "773-493-7040",
            "fax_number": "773-493-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7257 S JEFFERY BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493014",
            "telephone_number": "773-493-7040",
            "fax_number": "773-493-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA L JOHNSON MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "773-493-7041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036055866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180030052",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055856",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21608627",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.