1093217036 NPI number — ARNOLD ARELLANO LCPED, CPOA, CFO

Table of content: ARNOLD ARELLANO LCPED, CPOA, CFO (NPI 1093217036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093217036 NPI number — ARNOLD ARELLANO LCPED, CPOA, CFO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARELLANO
Provider First Name:
ARNOLD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPED, CPOA, CFO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093217036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1S376 SUMMIT AVE
Provider Second Line Business Mailing Address:
COURT E
Provider Business Mailing Address City Name:
OAKBROOK TERRACE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60181-3985
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-705-4092
Provider Business Mailing Address Fax Number:
630-424-0467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5202 OLD ORCHARD ROAD
Provider Second Line Business Practice Location Address:
N100
Provider Business Practice Location Address City Name:
SKOKIE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-475-7080
Provider Business Practice Location Address Fax Number:
847-475-0241
Provider Enumeration Date:
03/06/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 224L00000X , with the licence number:  CPED3591 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com