Provider Demographics
NPI:1568197739
Name:JOHNSON, SABRINA LINDSEY
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:LINDSEY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 ROTTERDAM DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-2621
Mailing Address - Country:US
Mailing Address - Phone:708-691-3858
Mailing Address - Fax:
Practice Address - Street 1:69 ROTTERDAM DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-2621
Practice Address - Country:US
Practice Address - Phone:708-691-3858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No385H00000XRespite Care FacilityRespite Care
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No253Z00000XAgenciesIn Home Supportive Care