Provider Demographics
NPI:1386941748
Name:EYELAND OPTICAL CORPORATION
Entity type:Organization
Organization Name:EYELAND OPTICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:SALVATORE
Authorized Official - Last Name:ARENELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-892-5000
Mailing Address - Street 1:26 E DOWNER PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3302
Mailing Address - Country:US
Mailing Address - Phone:630-892-5000
Mailing Address - Fax:
Practice Address - Street 1:26 E DOWNER PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3302
Practice Address - Country:US
Practice Address - Phone:630-892-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No305S00000XManaged Care OrganizationsPoint of Service