Provider Demographics
NPI:1184846032
Name:ARLINGTON EYE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:ARLINGTON EYE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SMAJO
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMANOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-394-1414
Mailing Address - Street 1:1604 W CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2407
Mailing Address - Country:US
Mailing Address - Phone:847-394-1414
Mailing Address - Fax:847-394-5380
Practice Address - Street 1:1604 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2407
Practice Address - Country:US
Practice Address - Phone:847-394-1414
Practice Address - Fax:847-394-5380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097049207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632914OtherBCBS
IL036097049Medicaid
IL180045934OtherRAILROAD MEDICARE
G95211Medicare UPIN
203921Medicare ID - Type Unspecified
4709660001Medicare NSC