Organization
VISION SALON EYE CARE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANSEL T JOHNSON OD (PRESIDENT)
(773) 783-4424
Entity
Organization
Contact information
Practice address
840 E 87TH ST, SUITE 100, CHICAGO, IL 60619-6248
(773) 783-4424
(773) 783-3340
Mailing address
840 E 87TH ST, SUITE 100, CHICAGO, IL 60619-6248
(773) 783-4424
(773) 783-3340
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
10/11/2006
Last updated
08/22/2020
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