Provider Demographics
NPI:1003845413
Name:JOHNSTON, NORMAN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:PATRICK
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 N NORTH BRANCH ST
Mailing Address - Street 2:210
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2473
Mailing Address - Country:US
Mailing Address - Phone:312-939-5090
Mailing Address - Fax:312-640-4496
Practice Address - Street 1:1229 N NORTH BRANCH ST
Practice Address - Street 2:210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2473
Practice Address - Country:US
Practice Address - Phone:312-939-5090
Practice Address - Fax:312-640-4496
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine