Active NPI 1407005218 Individual Practitioner Male Practitioner

Dr. Evan Dean Johnson , MD

Dermatology • St. Charles, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Evan Johnson, MD is a certified Dermatology practicing in St. Charles, IL. With approximately 21 years of clinical experience since completing medical education in 2005, 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 601754220

Telephone 6302322885

Fax 6302329936

Associated Practice Facility / Clinic

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

Medicare Profile & Education

Medical School

Other

Graduation Year

2005

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

21 Yrs -5.0 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

46.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Johnson (21 Years) 21 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	900	728	$180.00	$124.07
17003 Destruction of precancer skin growth, 2-14 growths	461	183	$26.00	$6.34
99213 Established patient office or other outpatient visit, typically 15 minutes	363	256	$124.00	$87.93
17000 Destruction of skin growth	325	289	$117.00	$62.71
17110 Destruction of up to 14 skin growths	198	179	$162.00	$108.17
11104 Punch biopsy, first skin growth	86	86	$184.00	$118.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	81	81	$240.00	$162.73
11900 Injection into skin growth, 1-7 growths	44	29	$104.00	$53.33
11901 Injection into skin growth, more than 7 growths	32	22	$116.00	$67.59
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$156.00	$109.53
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	24	22	$462.00	$145.78
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	19	19	$550.00	$373.67
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$110.00	$70.78
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	15	$450.00	$191.65
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	15	15	$589.00	$172.79
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	14	11	$575.00	$354.18
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	13	13	$605.00	$374.86
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	13	13	$500.00	$328.41
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$245.00	$173.09
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	12	12	$503.00	$161.95
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$282.00	$138.90
11105 Punch biopsy, each additional skin growth	11	11	$87.00	$57.32
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	11	11	$693.00	$451.14
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$513.00	$164.73

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	848	706	$180.00	$132.58
17003 Destruction of precancer skin growth, 2-14 growths	480	190	$26.00	$6.95
99213 Established patient office or other outpatient visit, typically 15 minutes	403	287	$123.42	$93.60
17000 Destruction of skin growth	337	285	$117.00	$63.61
17110 Destruction of up to 14 skin growths	161	146	$162.00	$116.76
11104 Punch biopsy, first skin growth	119	108	$184.00	$129.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	90	90	$240.00	$172.30
11901 Injection into skin growth, more than 7 growths	63	30	$116.00	$72.40
11900 Injection into skin growth, 1-7 growths	37	28	$104.00	$55.49
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	27	26	$605.00	$400.13
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$156.00	$117.88
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	22	22	$503.00	$172.25
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	20	18	$693.00	$461.90
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	19	18	$575.00	$365.85
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	17	$450.00	$238.32
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$110.00	$75.91
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	15	$462.00	$166.36
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	13	$353.00	$176.45
11105 Punch biopsy, each additional skin growth	15	15	$87.00	$62.85
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$513.00	$180.23
11606 Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm	11	11	$704.00	$476.51

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	761	618	$180.00	$134.34
17003 Destruction of precancer skin growth, 2-14 growths	597	207	$26.00	$7.19
99213 Established patient office or other outpatient visit, typically 15 minutes	401	292	$121.09	$95.77
17000 Destruction of skin growth	373	304	$117.00	$65.86
17110 Destruction of up to 14 skin growths	110	104	$162.00	$115.75
11104 Punch biopsy, first skin growth	104	100	$184.00	$134.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	80	80	$240.00	$177.03
11901 Injection into skin growth, more than 7 growths	70	35	$116.00	$74.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$156.00	$119.58
11900 Injection into skin growth, 1-7 growths	31	27	$104.00	$59.87
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	19	$353.00	$192.32
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	20	$360.00	$243.82
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$110.00	$77.59
11105 Punch biopsy, each additional skin growth	18	17	$87.00	$64.13
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	16	$513.00	$187.11
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	15	15	$375.00	$229.76
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	15	15	$550.00	$418.58
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	14	14	$589.00	$218.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$80.46	$60.27
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	11	11	$462.00	$219.00
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	11	11	$282.00	$162.48

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	643	539	$179.43	$137.74
17003 Destruction of precancer skin growth, 2-14 growths	636	199	$25.73	$6.96
99213 Established patient office or other outpatient visit, typically 15 minutes	412	286	$120.58	$97.14
17000 Destruction of skin growth	344	276	$117.00	$63.87
17110 Destruction of up to 14 skin growths	105	102	$162.00	$115.35
11104 Punch biopsy, first skin growth	103	98	$184.04	$132.40
11901 Injection into skin growth, more than 7 growths	74	30	$116.00	$74.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	70	54	$77.83	$59.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$240.00	$178.93
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$156.00	$119.99
99202 New patient office or other outpatient visit, typically 20 minutes	23	23	$109.63	$78.13
11900 Injection into skin growth, 1-7 growths	23	17	$104.00	$56.93
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	19	18	$513.00	$185.85
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	15	$353.00	$187.26
11105 Punch biopsy, each additional skin growth	17	16	$87.00	$66.22
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	15	15	$425.00	$289.27
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	14	$462.00	$229.13
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	14	14	$350.00	$230.42
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	13	13	$375.00	$222.02
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	13	$430.00	$270.43
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	11	11	$589.00	$299.00
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	11	11	$325.00	$252.17

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	564	478	$159.33	$115.36
17003 Destruction of precancer skin growth, 2-14 growths	525	181	$26.00	$6.32
99213 Established patient office or other outpatient visit, typically 15 minutes	353	248	$109.32	$79.65
17000 Destruction of skin growth	310	261	$117.00	$60.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	124	97	$75.00	$48.69
11104 Punch biopsy, first skin growth	107	100	$175.00	$126.93
17110 Destruction of up to 14 skin growths	86	81	$162.00	$117.31
11901 Injection into skin growth, more than 7 growths	78	31	$116.00	$72.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$240.00	$175.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$156.00	$115.25
11900 Injection into skin growth, 1-7 growths	24	19	$104.00	$54.84
11105 Punch biopsy, each additional skin growth	20	18	$86.00	$65.33
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	19	19	$353.00	$179.82
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	17	17	$589.00	$264.30
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	16	16	$513.00	$201.48
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	16	16	$350.00	$225.24
12051 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	14	14	$425.00	$210.84
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	14	$462.00	$249.50
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	13	13	$289.00	$219.80
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$110.00	$81.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	768	247	$25.93	$6.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	672	571	$150.00	$113.78
99213 Established patient office or other outpatient visit, typically 15 minutes	446	317	$100.00	$77.80
17000 Destruction of skin growth	401	325	$117.00	$60.19
11104 Punch biopsy, first skin growth	169	159	$174.85	$127.17
17110 Destruction of up to 14 skin growths	132	123	$162.00	$111.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	123	104	$75.00	$47.44
11901 Injection into skin growth, more than 7 growths	89	38	$116.00	$71.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	51	51	$156.00	$114.65
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	$173.70
99202 New patient office or other outpatient visit, typically 20 minutes	34	34	$110.00	$80.58
11900 Injection into skin growth, 1-7 growths	30	25	$104.00	$54.17
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	28	27	$550.00	$410.82
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	24	22	$513.00	$158.39
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	20	$353.00	$188.71
11105 Punch biopsy, each additional skin growth	18	18	$86.00	$64.99
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	15	$462.00	$145.22
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	16	16	$589.00	$172.10
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	15	12	$425.00	$390.87
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	15	15	$500.00	$358.22
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	14	12	$190.00	$131.00
11102 Tangential biopsy of single skin lesion	13	13	$140.00	$93.03
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	12	12	$289.00	$216.28
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	12	12	$55.00	$23.90
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$462.00	$220.35

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	694	568	$150.00	$106.59
17003 Destruction of precancer skin growth, 2-14 growths	640	219	$26.00	$5.40
99213 Established patient office or other outpatient visit, typically 15 minutes	478	358	$100.00	$71.98
17000 Destruction of skin growth	341	292	$117.00	$55.73
11100 Biopsy of single growth of skin and/or tissue	164	151	$150.00	$90.74
17110 Destruction of up to 14 skin growths	159	147	$162.00	$108.19
11901 Injection into skin growth, more than 7 growths	90	37	$116.00	$68.73
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	$107.01
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	63	62	$75.00	$42.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$210.00	$164.59
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	43	42	$353.00	$169.29
11900 Injection into skin growth, 1-7 growths	41	30	$104.00	$51.91
11101 Biopsy of each additional growth of skin and/or tissue	29	27	$86.00	$33.16
99202 New patient office or other outpatient visit, typically 20 minutes	27	27	$110.00	$74.95
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	24	24	$589.00	$162.53
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	24	23	$540.00	$390.40
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	23	22	$601.09	$366.41
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	21	$513.00	$170.68
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	19	18	$693.00	$469.41
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	19	17	$462.00	$152.26
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	15	13	$533.33	$386.84
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$350.00	$184.28
13120 Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm	13	13	$500.00	$354.73
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	13	$205.00	$143.82
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	12	11	$190.00	$114.26
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	12	12	$282.00	$133.39
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	12	11	$425.00	$398.12
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	11	11	$289.00	$189.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	737	220	$26.00	$5.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	681	559	$144.30	$105.23
99213 Established patient office or other outpatient visit, typically 15 minutes	532	390	$96.15	$71.95
17000 Destruction of skin growth	378	314	$117.00	$55.60
17110 Destruction of up to 14 skin growths	158	149	$162.00	$104.48
11100 Biopsy of single growth of skin and/or tissue	148	137	$150.00	$93.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	96	96	$156.00	$107.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	86	84	$75.00	$42.74
11901 Injection into skin growth, more than 7 growths	66	28	$116.00	$67.70
11101 Biopsy of each additional growth of skin and/or tissue	49	38	$86.00	$32.91
99202 New patient office or other outpatient visit, typically 20 minutes	39	39	$110.00	$73.18
11900 Injection into skin growth, 1-7 growths	33	30	$104.00	$50.57
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	33	30	$353.00	$156.23
13131 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm	22	22	$520.00	$386.31
11640 Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips	19	19	$289.00	$195.30
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	18	17	$190.00	$133.82
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	18	17	$425.00	$355.10
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	16	$513.00	$136.32
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	15	13	$693.00	$477.41
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	14	$575.00	$397.20
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$350.00	$219.91
11604 Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm	11	11	$503.00	$158.52
13100 Complicated repair of wound of trunk, 1.1-2.5 cm	11	11	$475.00	$304.57
11601 Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs	11	11	$250.00	$229.11

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License IL 036.121856

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.

Hospital & Practice Group Affiliations

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

3310 W Main St, St Charles, IL 601757649

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. Lawrence Johnson , MD

Dermatology

NPI 1114015351

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 April 03, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 03, 2017

Registered at 3310 W. MAIN STREET, SUITE 115, ST. CHARLES, IL 601754220 (Tel: 6302322885)

📍

Updated Business Mailing Address April 03, 2017

Registered at 3310 W. MAIN STREET, SUITE 115, ST. CHARLES, IL 601754220 (Tel: 6302322885)

👤

Provider Name / Credentials Updated April 03, 2017

Recorded as EVAN JOHNSON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2017

Dermatology (License #036.121856 in IL)

✅

NPI Profile Active September 17, 2008

NPI status registered as active in NPPES database

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Updated Practice Location September 17, 2008

Registered at 351 DELNOR DR, STE # 400, GENEVA, IL 601344220 (Tel: 6302322885)

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Updated Business Mailing Address September 17, 2008

Registered at 351 DELNOR DR, STE # 400, GENEVA, IL 601344220 (Tel: 6302322885)

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Provider Name / Credentials Updated September 17, 2008

Recorded as EVAN JOHNSON, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2008

Dermatology (License #036.121856 in IL)

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Initial NPI Registration & Enumeration September 17, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1407005218

Entity Type:

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

Enumeration Date: September 17, 2008

Last Update: April 03, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

3310 W. Main Street, Suite 115

St. Charles, IL 601754220

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.