Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ebony Nicole Johnson, MD

Individual provider Family Medicine Physician · NPI 1497847255

Ebony Nicole Johnson, MD is a Family Practice in Crestwood, Illinois. Graduated from Ohio State University College of Medicine in 2005, 21 years ago. Practices with Ucm Medical Group Sub LLC, a 99-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
21
Trained at
Ohio State University College of Medicine
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4742 Cal Sag Rd
Crestwood, IL 60418
Phone: (708) 915-2727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 03612077 (IL)

Record details

NPI number1497847255
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 29, 2006
Last updated in NPPESJuly 23, 2018
Mailing address27702 Network Pl, Chicago, IL 60673-1277

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Ucm Medical Group Sub Llc — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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