Provider Demographics
NPI:1396885737
Name:WARNER, TROY LAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:LAYNE
Last Name:WARNER
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:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:IL
Mailing Address - Zip Code:62468-0068
Mailing Address - Country:US
Mailing Address - Phone:217-849-3499
Mailing Address - Fax:
Practice Address - Street 1:102 COURTHOUSE SQ.
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:IL
Practice Address - Zip Code:62428
Practice Address - Country:US
Practice Address - Phone:217-849-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01822759OtherBLUE CROSS BLUE SHIELD
ILU75340Medicare UPIN
IL544840Medicare ID - Type Unspecified