Provider Demographics
NPI:1447602313
Name:WARNICKI, DANIEL DONALD
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DONALD
Last Name:WARNICKI
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 1:14938 KILDARE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-3340
Mailing Address - Country:US
Mailing Address - Phone:708-227-6563
Mailing Address - Fax:
Practice Address - Street 1:14938 KILDARE AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3340
Practice Address - Country:US
Practice Address - Phone:708-227-6563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst