LEONIDAS A JOHNSON OD NPI 1912022641

NPI Information

NPI: 1912022641
Provider Name: LEONIDAS A JOHNSON, OD
Classification:
Entity Type: Individual

PECOS Registration: Yes

Address:
12812 WESTERN AVE
BLUE ISLAND, IL
ZIP 60406
Phone: (708) 385-0013
Get Directions

Leonidas A Johnson, OD is a healthcare provider in Blue Island, IL. Leonidas A Johnson, OD NPI is 1912022641. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduation Year:1985

The provider's business location address is:

12812 WESTERN AVE
BLUE ISLAND, IL
ZIP 60406-118
Phone: (708) 385-0013

The NPI 1912022641 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/20/2007 and was last updated on 10/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152W00000X	Optometrist		8254	CALIFORNIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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