Provider Demographics
NPI:1093217036
Name:ARELLANO, ARNOLD (LCPED, CPOA, CFO)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:M
Credentials:LCPED, CPOA, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1S376 SUMMIT AVE
Mailing Address - Street 2:COURT E
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3985
Mailing Address - Country:US
Mailing Address - Phone:630-705-4092
Mailing Address - Fax:630-424-0467
Practice Address - Street 1:5202 OLD ORCHARD ROAD
Practice Address - Street 2:N100
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-475-7080
Practice Address - Fax:847-475-0241
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCPED3591224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist