Individual provider · Type 1 NPI

Rochelle A. Johnson

Nurse Practitioner · Waukegan, IL

NPI number 1104416163 Active

Practice location

3210 Grand Ave
Waukegan, IL 60085-2204

Mailing address

PO Box 746715
Atlanta, GA 30374-6715

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X209.022683 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104416163

Rochelle A. Johnson's National Provider Identifier is 1104416163, issued on Jan 24, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Waukegan, IL. The record was last updated on Jun 10, 2025.