| Dr Carl Winston Johnson Ii, MD | |
|
6703 W 159th Street, Suite 110, Tinley Park, IL 60477 | |
| (708) 331-1122 | |
| (708) 331-5987 |
| Full Name | Dr Carl Winston Johnson Ii |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 6703 W 159th Street, Tinley Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467450122 | NPI | - | NPPES |
| 36107266 | Medicaid | IL | |
| 363950/L93169 | Other | IL | MEDICARE GROUP/PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 36107266 (Illinois) | Primary |
| Entity Name | Signify Health Medical Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20190507001451 |
| Entity Name | Pro Health One Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053714584 PECOS PAC ID: 2466778089 Enrollment ID: O20201118002076 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Carl Winston Johnson Ii, MD 6703 W 159th Street, Suite 110, Tinley Park, IL 60477 Ph: (708) 331-1122 | Dr Carl Winston Johnson Ii, MD 6703 W 159th Street, Suite 110, Tinley Park, IL 60477 Ph: (708) 331-1122 |
Dr. Gary R Peplinski, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 6703 W 159th Street, Suite 110, Tinley Park, IL 60477 Phone: 708-331-1122 Fax: 708-331-5987 | |
Dr. Patrick Coffey, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 8505 183rd St Ste A, Tinley Park, IL 60487 Phone: 815-824-4406 | |
Mengdi Yao, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 8505 183rd St Ste A, Tinley Park, IL 60487 Phone: 815-824-4406 | |
Dr. Joslyn M Albright, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 18210 La Grange Rd Ste 105, Tinley Park, IL 60487 Phone: 708-478-4407 Fax: 708-478-4007 | |
Felipe Gracias, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 17495 La Grange Rd, Tinley Park, IL 60487 Phone: 815-416-6641 Fax: 630-432-6604 |