SearchIllinoisGeneral Practice Physician

Theodore Johnson, MD

NPI 1609523240 · on the registry since 2022

Practice

Address
3410 Illinois St
Great Lakes, IL 60088
Phone
(224) 610-8553
Clinicians at this address
6

Registry record

Primary taxonomy
General Practice Physician
208D00000X
Also registered as
Military Health Care Provider
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-07-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois