Search › Illinois › 152W00000X
Ansel Johnson, OD
NPI 1023106309 · on the registry since 2006 · sole proprietor
Practice
- Address
- 12812 Western Ave
Blue Island, IL 60406 - Phone
- (708) 385-0013
- Fax
- (708) 385-1175
- Organisation at this address
- The Vision Salon, Ltd.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-09-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois