Individual provider · Type 1 NPI
Johnny Ifopo
Other Specialist/Technologist · Great Lakes, IL
NPI number
1083409973
Active
Practice location
2410 Sampson St
Great Lakes, IL 60088-2942
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Other Specialist/Technologist Primary | 246Z00000X | None listed |
Other Specialist/Technologist: General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.
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About NPI 1083409973
Johnny Ifopo's National Provider Identifier is 1083409973, issued on Apr 11, 2025. The primary taxonomy on file is Other Specialist/Technologist (246Z00000X), and the practice location is in Great Lakes, IL. The record was last updated on Apr 11, 2025.