Individual
DR. ANSEL T JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
12812 WESTERN AVE, BLUE ISLAND, IL 60406-2118
(708) 385-0013
(708) 385-1175
Mailing address
12812 WESTERN AVE, BLUE ISLAND, IL 60406-2118
(708) 385-0013
(708) 385-1175
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007826
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007826
—
IL
01
—
0718670001
DMERC PIN
IL
01
—
1636075
BCBSIL ID
IL
01
—
363718601
TAX ID
IL
01
—
410011831
RAIL ROAD MEDICARE PIN
—
Enumeration date
10/11/2006
Last updated
09/21/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us