Healthcare Provider Details

I. General information

NPI: 1992168652
Provider Name (Legal Business Name): JOSHUA WARREN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N HARBOR DR APT 2407
CHICAGO IL
60601-5007
US

IV. Provider business mailing address

155 N HARBOR DR APT 2407
CHICAGO IL
60601-5007
US

V. Phone/Fax

Practice location:
  • Phone: 414-526-2346
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number296005
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: