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Organization

OPTIMUM VISION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONNA JOHNSON MD (PHYSICIAN)
(773) 752-3900
Entity
Organization

Contact information

Practice address
7257 S JEFFERY BLVD, CHICAGO, IL 60649-3014
(773) 752-3900
(773) 493-8837
Mailing address
7257 S JEFFERY BLVD, CHICAGO, IL 60649-3014
(773) 752-3900
(773) 493-8837

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
036055856
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18175
DAVIS EYE VISION
01
919248
EYE MED
IL
01
921513
BLOCK VISION
Enumeration date
07/23/2008
Last updated
07/23/2008
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