Healthcare Provider Details

I. General information

NPI: 1013749290
Provider Name (Legal Business Name): DILLON T. WARNECKE APN-CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W. CENTRAL RD. DEPARTMENT OF ANESTHESIA
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

2650 RIDGE AVE SUITE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-7140
  • Fax: 847-618-0228
Mailing address:
  • Phone: 847-618-7140
  • Fax: 847-618-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209035705
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.482251
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: