Active NPI 1114015351 Individual Practitioner Male Practitioner

Dr. Lawrence L Johnson , MD

Dermatology • St. Charles, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Lawrence Johnson, MD is a certified Dermatology practicing in St. Charles, IL. With approximately 52 years of clinical experience since graduating from Rush Medical College Of Rush University in 1974, Dr. Johnson delivers high-quality medical care to the local community at 3310 W. MAIN STREET.

Dr. Johnson is affiliated with Lawrence L. Johnson, M.D., S.C. and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, destruction of precancer skin growth, 2-14 growths, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3310 W. Main Street
Suite 115

St. Charles, IL 60175

Telephone 6302322885

Fax 6302329936

Associated Practice Facility / Clinic

🏢 Lawrence L. Johnson, M.d., S.c. Facility NPI 1376629626

Medicare Profile & Education

Medical School

Rush Medical College Of Rush University

Graduation Year

1974

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in St. Charles, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

52 Yrs +26.0 yrs vs City Avg

City Avg: 26.0 Yrs

State Avg: 23.1 Yrs

Regional Practice Density

5 Specialists

Practicing in St. Charles, IL (673 Statewide)

Telehealth Adoption Rate

40.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

40.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Johnson (52 Years) 52 Yrs

St. Charles Specialty Average (26.0 Years) 26.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,529	1,142	$180.00	$126.90
99213 Established patient office or other outpatient visit, typically 15 minutes	724	486	$124.04	$89.99
17003 Destruction of precancer skin growth, 2-14 growths	514	114	$26.00	$6.51
17000 Destruction of skin growth	217	171	$117.00	$62.52
11104 Punch biopsy, first skin growth	202	180	$184.00	$123.67
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	144	144	$156.00	$110.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	106	92	$78.00	$55.76
17110 Destruction of up to 14 skin growths	98	88	$162.00	$111.32
11900 Injection into skin growth, 1-7 growths	33	17	$104.00	$56.28
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	30	29	$450.00	$219.63
17004 Destruction of precancer skin growth, 15 or more growths	26	19	$236.00	$165.75
11901 Injection into skin growth, more than 7 growths	25	13	$116.00	$69.71
11105 Punch biopsy, each additional skin growth	21	21	$87.00	$59.09
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	15	$289.00	$134.77
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	15	15	$444.00	$236.01
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	13	11	$353.00	$163.76
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$349.00	$223.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$240.00	$165.43
11102 Tangential biopsy of single skin lesion	12	11	$146.25	$99.58
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$110.00	$71.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,427	1,056	$180.00	$132.81
99213 Established patient office or other outpatient visit, typically 15 minutes	769	516	$123.41	$93.83
17003 Destruction of precancer skin growth, 2-14 growths	452	98	$26.00	$6.99
11104 Punch biopsy, first skin growth	213	198	$184.00	$133.42
17000 Destruction of skin growth	163	143	$117.00	$67.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	136	136	$156.00	$117.70
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	115	102	$78.00	$59.12
11901 Injection into skin growth, more than 7 growths	70	29	$116.00	$73.03
17110 Destruction of up to 14 skin growths	45	35	$162.00	$118.79
11900 Injection into skin growth, 1-7 growths	31	22	$104.00	$60.27
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	26	25	$513.00	$250.51
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	24	22	$450.00	$226.84
17004 Destruction of precancer skin growth, 15 or more growths	23	18	$235.61	$178.95
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	15	$289.00	$146.87
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	14	13	$444.00	$233.32
11102 Tangential biopsy of single skin lesion	12	12	$146.25	$107.70
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	11	11	$353.00	$189.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,154	879	$180.00	$134.57
99213 Established patient office or other outpatient visit, typically 15 minutes	846	612	$121.00	$95.75
17003 Destruction of precancer skin growth, 2-14 growths	467	99	$26.00	$7.18
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	223	175	$78.00	$60.10
11104 Punch biopsy, first skin growth	197	184	$184.00	$136.18
17000 Destruction of skin growth	160	137	$117.00	$66.81
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	136	136	$156.00	$119.39
17110 Destruction of up to 14 skin growths	57	54	$162.00	$115.73
11901 Injection into skin growth, more than 7 growths	38	23	$116.00	$73.97
17004 Destruction of precancer skin growth, 15 or more growths	31	20	$233.00	$181.05
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	23	23	$371.74	$171.78
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	23	21	$375.00	$262.80
11900 Injection into skin growth, 1-7 growths	20	14	$104.00	$60.79
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	20	19	$289.00	$155.13
11105 Punch biopsy, each additional skin growth	20	19	$87.00	$64.08
11102 Tangential biopsy of single skin lesion	20	20	$146.25	$110.58
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	19	19	$513.00	$212.71
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	19	17	$444.00	$248.89
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$110.00	$77.50
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	13	13	$375.00	$185.90
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$282.00	$169.63
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	11	11	$335.00	$144.51
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$240.00	$176.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,188	850	$120.74	$96.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	756	629	$179.39	$137.47
17003 Destruction of precancer skin growth, 2-14 growths	696	154	$25.85	$6.96
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	350	275	$77.93	$59.81
17000 Destruction of skin growth	262	226	$117.00	$66.89
11104 Punch biopsy, first skin growth	206	183	$183.78	$140.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	125	125	$155.43	$119.71
17110 Destruction of up to 14 skin growths	119	111	$162.00	$118.04
11901 Injection into skin growth, more than 7 growths	88	38	$116.00	$73.56
17004 Destruction of precancer skin growth, 15 or more growths	40	27	$243.15	$179.05
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	30	29	$289.00	$155.46
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	30	30	$350.33	$168.46
11900 Injection into skin growth, 1-7 growths	28	22	$104.00	$57.64
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$110.00	$78.13
11105 Punch biopsy, each additional skin growth	22	17	$86.86	$66.22
11102 Tangential biopsy of single skin lesion	19	19	$146.25	$109.54
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	16	16	$375.00	$193.93
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	15	15	$325.00	$252.17
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	14	13	$50.91	$15.02
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	13	13	$550.00	$429.94
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	13	13	$513.00	$192.40
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	12	12	$353.00	$192.93
13100 Complicated repair of wound of trunk, 1.1-2.5 cm	11	11	$475.00	$379.15
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	11	11	$500.00	$386.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	971	769	$109.62	$79.86
17003 Destruction of precancer skin growth, 2-14 growths	767	183	$26.00	$6.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	468	425	$158.89	$115.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	316	244	$75.00	$48.59
17000 Destruction of skin growth	309	271	$117.38	$66.70
17110 Destruction of up to 14 skin growths	202	183	$162.00	$116.40
11104 Punch biopsy, first skin growth	149	140	$175.00	$135.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	79	79	$156.00	$114.28
11901 Injection into skin growth, more than 7 growths	63	33	$116.00	$72.67
17004 Destruction of precancer skin growth, 15 or more growths	36	30	$436.00	$170.16
99202 New patient office or other outpatient visit, typically 20 minutes	27	27	$110.00	$81.39
11900 Injection into skin growth, 1-7 growths	22	18	$104.00	$58.01
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	22	21	$55.00	$24.61
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	18	17	$350.00	$156.30
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	15	$289.00	$146.68
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	15	15	$500.00	$386.52
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	12	$513.00	$198.15
11105 Punch biopsy, each additional skin growth	12	12	$86.00	$65.45
11102 Tangential biopsy of single skin lesion	11	11	$140.00	$103.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$240.00	$175.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,272	992	$150.00	$113.74
17003 Destruction of precancer skin growth, 2-14 growths	1,185	269	$26.00	$6.09
99213 Established patient office or other outpatient visit, typically 15 minutes	613	471	$100.09	$77.40
17000 Destruction of skin growth	496	393	$117.00	$63.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	413	330	$75.00	$47.40
17110 Destruction of up to 14 skin growths	244	224	$162.00	$111.02
11104 Punch biopsy, first skin growth	231	205	$175.00	$131.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	71	71	$156.00	$114.57
11901 Injection into skin growth, more than 7 growths	71	38	$116.00	$72.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$210.00	$173.34
11900 Injection into skin growth, 1-7 growths	44	29	$104.00	$55.43
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	42	37	$55.00	$23.82
17004 Destruction of precancer skin growth, 15 or more growths	36	32	$436.00	$162.38
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	32	31	$500.00	$371.50
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	30	28	$350.00	$131.92
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	29	27	$289.00	$144.11
99202 New patient office or other outpatient visit, typically 20 minutes	22	22	$110.00	$80.63
11105 Punch biopsy, each additional skin growth	21	19	$86.00	$64.99
11102 Tangential biopsy of single skin lesion	20	20	$140.00	$105.43
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	20	19	$282.00	$162.27
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	19	19	$375.00	$186.98
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	19	18	$550.00	$418.32
13100 Complicated repair of wound of trunk, 1.1-2.5 cm	16	16	$475.00	$334.29
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	13	$513.00	$146.24
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	14	14	$444.00	$242.03
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	14	14	$325.00	$245.87
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$335.00	$104.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,315	272	$26.00	$5.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,309	1,007	$150.00	$106.08
99213 Established patient office or other outpatient visit, typically 15 minutes	652	473	$100.00	$72.26
17000 Destruction of skin growth	498	396	$117.00	$61.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	445	343	$75.00	$43.55
17110 Destruction of up to 14 skin growths	311	279	$162.00	$110.67
11100 Biopsy of single growth of skin and/or tissue	271	252	$150.00	$97.75
11901 Injection into skin growth, more than 7 growths	106	42	$116.00	$70.50
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	83	83	$156.00	$107.51
11101 Biopsy of each additional growth of skin and/or tissue	53	44	$86.00	$32.51
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$210.00	$160.93
11900 Injection into skin growth, 1-7 growths	46	30	$104.00	$53.70
17004 Destruction of precancer skin growth, 15 or more growths	45	34	$436.00	$146.12
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	38	36	$289.00	$132.59
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	37	36	$55.00	$21.44
99202 New patient office or other outpatient visit, typically 20 minutes	25	25	$110.00	$75.36
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	22	21	$543.18	$390.33
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	21	19	$425.00	$398.12
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	20	19	$190.00	$114.56
11641 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	20	18	$444.00	$216.70
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	20	20	$298.75	$226.21
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	17	16	$350.00	$133.29
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	16	14	$500.00	$354.75
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	15	14	$375.00	$174.52
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	14	$353.00	$166.10
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$513.00	$137.94
17280 Destruction of malignant growth (0.5 centimeters or less) of face, ears, eyelids, nose, lips, or mouth	11	11	$289.00	$143.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,496	302	$26.00	$5.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,195	942	$144.70	$105.65
99213 Established patient office or other outpatient visit, typically 15 minutes	618	453	$95.91	$71.56
17000 Destruction of skin growth	552	425	$117.00	$61.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	441	331	$75.00	$43.05
17110 Destruction of up to 14 skin growths	291	247	$162.00	$108.39
11100 Biopsy of single growth of skin and/or tissue	227	197	$150.00	$99.01
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	108	108	$156.00	$106.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	83	79	$205.00	$141.68
11901 Injection into skin growth, more than 7 growths	62	36	$116.00	$66.85
99202 New patient office or other outpatient visit, typically 20 minutes	42	42	$110.00	$74.43
11900 Injection into skin growth, 1-7 growths	42	26	$104.00	$50.37
11101 Biopsy of each additional growth of skin and/or tissue	37	29	$86.00	$32.91
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	37	32	$289.00	$124.04
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	34	26	$425.00	$355.30
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	34	26	$190.00	$133.90
17004 Destruction of precancer skin growth, 15 or more growths	27	21	$436.00	$150.11
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	22	21	$350.00	$135.74
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	19	16	$353.00	$161.01
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$210.00	$162.33
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	17	17	$250.00	$229.11
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	17	14	$375.00	$163.31
13100 Complicated repair of wound of trunk, 1.1-2.5 cm	16	16	$475.00	$335.02
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	15	13	$55.00	$19.78
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	15	15	$282.00	$144.20
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	14	14	$500.00	$350.57
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	12	12	$520.00	$386.31
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$513.00	$136.32

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License IL 036 052717

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Blue Cross Blue Shield Id

0004500588 (IL)

Hospital & Practice Group Affiliations

Lawrence L. Johnson, M.d., S.c.

3310 W Main St, St Charles, IL 601751029

Phone: 6302322885

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Evan Johnson , MD

Dermatology

NPI 1407005218

Doctor of Medicine (M.D.)

Jean Born , PA-C

Physician Assistant

NPI 1821229501

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active March 31, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location March 31, 2017

Registered at 3310 W. MAIN STREET, SUITE 115, ST. CHARLES, IL 60175 (Tel: 6302322885)

📍

Updated Business Mailing Address March 31, 2017

Registered at 3310 W. MAIN STREET, SUITE 115, ST. CHARLES, IL 60175 (Tel: 6302322885)

👤

Provider Name / Credentials Updated March 31, 2017

Recorded as LAWRENCE JOHNSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 31, 2017

Dermatology (License #036 052717 in IL)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 351 DELNOR DR, STE 400, GENEVA, IL 601344209 (Tel: 6302322885)

📍

Updated Business Mailing Address July 08, 2007

Registered at 351 DELNOR DR, STE 400, GENEVA, IL 60134 (Tel: 6302322885)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as LAWRENCE JOHNSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dermatology

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Initial NPI Registration & Enumeration October 11, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114015351

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 11, 2006

Last Update: March 31, 2017

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

3310 W. Main Street, Suite 115

St. Charles, IL 60175

Phone: 6302322885

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.