Alexandra Lilia Johnson | Chicago, IL • PECOS Search

Alexandra Lilia Johnson

Social Worker

Behavioral Health & Social Service Providers

2551 N Clark St, Suite 800, Chicago, IL 60614-1798

PECOS Enrollment

Based on the most recent information from CMS, provider Alexandra Lilia Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1972887487
Provider Type
Individual
Full Name
Johnson, Alexandra Lilia
Credential
L.C.S.W.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/3/2011
Last Updated
11/20/2014

Contact Information

Practice Location

2551 N Clark St, Suite 800, Chicago, IL 60614-1798

Unlisted Fax

Mailing Location

2551 N Clark St, Suite 800, Chicago, IL 60614-1798

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149.016854 Illinois