Provider Demographics
NPI:1659602936
Name:A&R OPTICAL, INC.
Entity Type:Organization
Organization Name:A&R OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PALATNICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-891-3992
Mailing Address - Street 1:307 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-1516
Mailing Address - Country:US
Mailing Address - Phone:847-891-3992
Mailing Address - Fax:847-891-3992
Practice Address - Street 1:307 HICKORY LN
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-1516
Practice Address - Country:US
Practice Address - Phone:847-891-3992
Practice Address - Fax:847-891-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006675152W00000X
IL046008758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046006675Medicaid