Theodore Johnson, MD
Theodore Johnson, MD is a Military Health Care Provider in Great Lakes, Illinois. Licensed in Virginia. Registered with an NPI since 2022.
- Licensed in
- VA
- In the registry since
- 2022
- Specialties on file
- 2
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
3410 Illinois StGreat Lakes, IL 60088-3120
Phone: (224) 610-8553
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X · Licence 0101279593 (VA) |
|---|---|
| Military Health Care Provider | Taxonomy 171000000X · Licence 0101279593 (VA) |
Record details
| NPI number | 1609523240 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | March 3, 2022 |
| Last updated in NPPES | July 9, 2025 |
| Certification date | July 9, 2025 |
| Mailing address | 220 Hovey Rd, Pensacola, FL 32508-1044 |
Other providers in Great Lakes
-
Dr. Michael Hunter Anderson, MD
3001 6th St, Great Lakes, IL 60088-2833 · (847) 688-2492
-
Evan Fuchs
3410 Illinois St, Great Lakes, IL 60088-3120 · (847) 340-0495
-
Dr. Eden U Padilla, MD
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-
Dr. Matthew Turner, DDS
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