Johnson, Stephanie R.
Johnson, Stephanie R. is an individual health care provider with primary practice located at 5401 S Wentworth Ave Ste 14B , Chicago IL 60609-6300. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Vision Therapy is her primary health care specialty. Johnson, Stephanie R. can be contacted via phone (773) 924-5292.Contact Information
Primary practice address
5401 S Wentworth Ave Ste 14B
Chicago IL 60609-6300
Phone: (773) 924-5292
Fax: (773) 373-3548
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 46-7055 | Illinois |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 046007055 | Illinois |
Profile Details
| NPI number | 1992843007 |
|---|---|
| LBN Legal business name | Johnson, Stephanie R. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2007 |
| Last updated | Jan 18th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992843007 | NPPES |
| Illinois | MEDICAID | 0046007055 |
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