MEDICARE: GALILEO OPTICAL CO.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861823361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALILEO OPTICAL CO.

Provider Business Mailing Address
First Line	:	1449 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-8027
Country	:	US
Telephone Number	:	773-549-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1449 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-8027
Country	:	US
Telephone Number	:	773-549-2020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SALVATORE ARENELLA
Credential	:
Telephone Number	:	773-549-2020

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	01/09/2015

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Directions to “GALILEO OPTICAL CO. ” Practice Location

Language	Start Address	Practice Location

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