Provider Demographics
NPI:1447306451
Name:ARENELLA, SALVATORE
Entity type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:
Last Name:ARENELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 WATERBURY DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5277
Mailing Address - Country:US
Mailing Address - Phone:630-849-1307
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:630-896-7820
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician