MEDICARE: VISIONWORKS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1790900033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONWORKS INC

Provider Business Mailing Address
First Line	:	PO BOX 848448
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-8448
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	101 CHICAGO RIDGE MALL
Second Line	:	STE E1
City	:	CHICAGO RIDGE
State	:	IL
Zip	:	60415-2603
Country	:	US
Telephone Number	:	708-423-0791
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR - MVC
Name	:	DOROTHY REYNOLDS
Credential	:
Telephone Number	:	210-524-6515

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	04/14/2015

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Directions to “VISIONWORKS INC ” Practice Location

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