Individual ProviderCarl C. JohnsonFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1 Erie Ct, Suite 6040, Oak Park, IL 60302-2566(708) 386-1301PECOS EnrollmentBased on the most recent information from CMS, provider Carl C. Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1043398852Provider TypeIndividualFull NameJohnson, Carl C.CredentialMDGenderMaleSole ProprietorNoEnumeration Date11/1/2006Last Updated10/19/2025Contact InformationPractice LocationPractice Address1 Erie Ct, Suite 6040, Oak Park, IL 60302-2566Phone(708) 386-1301Fax(708) 386-3053Mailing LocationMailing Address1 Erie Ct, Suite 6040, Oak Park, IL 60302-2566Phone(708) 386-1301Fax(708) 386-3053Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036134028IllinoisCode207V00000XDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicenseA38603California