Provider Demographics
NPI:1427354174
Name:BJORK VISION LLC
Entity type:Organization
Organization Name:BJORK VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:R
Authorized Official - Last Name:BJORK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-708-5834
Mailing Address - Street 1:5626 DES PLAINES CT
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3203
Mailing Address - Country:US
Mailing Address - Phone:847-708-5834
Mailing Address - Fax:
Practice Address - Street 1:808 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CUBA CITY
Practice Address - State:WI
Practice Address - Zip Code:53807-1439
Practice Address - Country:US
Practice Address - Phone:847-708-5834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3203-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty