Individual ProviderAlice JohnsonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address21 W Millers Rd, Des Plaines, IL 60016-2844(847) 693-1836PECOS EnrollmentBased on the most recent information from CMS, provider Alice 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 2 days ago.Profile DetailsProvider ID1124773833Provider TypeIndividualFull NameJohnson, AliceTitleMrs.CredentialFNP-BCGenderFemaleSole ProprietorYesEnumeration Date2/21/2022Last Updated2/21/2022Contact InformationPractice LocationPractice Address21 W Millers Rd, Des Plaines, IL 60016-2844Phone(847) 693-1836FaxUnlisted FaxMailing LocationMailing Address21 W Millers Rd, Des Plaines, IL 60016-2844Phone(847) 693-1836FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209024809Illinois