Provider Demographics
NPI:1891931507
Name:JOHNSON-PERKINS, PATRICE A (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:A
Last Name:JOHNSON-PERKINS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:MS
Other - First Name:PATRICE
Other - Middle Name:ANN
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP-C
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:20002 WOLF RD
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1320
Practice Address - Country:US
Practice Address - Phone:800-323-8622
Practice Address - Fax:224-225-0373
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002831A363LF0000X
IL209007783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN260030AMedicare PIN