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1053563643
NICHOLAS WARNECKE
PEORIA, IL
NPI
1053563643
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085003358)
Enumeration Date
2008-10-15
Last Update Date
2008-10-15
Business Address
-- NICHOLAS WARNECKE PA-C
112 NE CRESCENT AVE
PEORIA, IL 61606-1901
Phone number: 309-672-4670
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Mailing Address
-- NICHOLAS WARNECKE PA-C
5100 RELIABLE PKWY
CHICAGO, IL 60686-0001
Phone number: 309-672-4809
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