Organization
THE VISION SALON, LTD.
Active
Other names
Vision Salon Eye Care Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANSEL T JOHNSON O.D. (PRESIDENT/OWNER)
(708) 385-0013
Entity
Organization
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636075
BCBS OF IL ID
IL
Enumeration date
11/15/2006
Last updated
11/24/2010
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