MEDICARE: ERIC C WARNER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05006379A	IN

General Provider Information

NPI Number	:	1578603619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC C WARNER PT

Provider Business Mailing Address
First Line	:	205 W WACKER DR
Second Line	:	SUITE 1020
City	:	CHICAGO
State	:	IL
Zip	:	60606-1216
Country	:	US
Telephone Number	:	312-640-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	3240 E 84TH PL
Second Line	:
City	:	MERRILLVILLE BRA
State	:	IN
Zip	:	46410-6549
Country	:	US
Telephone Number	:	219-791-0494
Fax Number	:	219-791-0490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	12/03/2008

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Directions to “ ERIC C WARNER PT” Practice Location

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