Provider Demographics
NPI:1497881684
Name:WARNER, JAMES A (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:WARNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 SPRING RD STE 215
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1350
Mailing Address - Country:US
Mailing Address - Phone:630-279-5321
Mailing Address - Fax:
Practice Address - Street 1:1550 SPRING RD STE 215
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1350
Practice Address - Country:US
Practice Address - Phone:630-279-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490029131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21843Medicare UPIN