Provider Demographics
NPI:1033714696
Name:WARNECKE, ANTHONY KARL (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:KARL
Last Name:WARNECKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N AYER ST
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:IL
Mailing Address - Zip Code:60033-2803
Mailing Address - Country:US
Mailing Address - Phone:815-943-9150
Mailing Address - Fax:
Practice Address - Street 1:50 N AYER ST
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:IL
Practice Address - Zip Code:60033-2803
Practice Address - Country:US
Practice Address - Phone:815-943-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013638111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor