Provider Demographics
NPI:1710132212
Name:JOHNSON, AARON THOMAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:THOMAS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N OAKLEY CT
Mailing Address - Street 2:APT 103
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-6182
Mailing Address - Country:US
Mailing Address - Phone:414-380-6440
Mailing Address - Fax:
Practice Address - Street 1:1103 N OAKLEY CT
Practice Address - Street 2:APT 103
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6182
Practice Address - Country:US
Practice Address - Phone:414-380-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15085-40183500000X
IL051.292445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist