Healthcare Provider Details

I. General information

NPI: 1699420265
Provider Name (Legal Business Name): TONY S. WARFIELD APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2022
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4709 GOLF RD FL 7
SKOKIE IL
60076-1231
US

IV. Provider business mailing address

1560 SHERMAN AVE STE 400
EVANSTON IL
60201-4803
US

V. Phone/Fax

Practice location:
  • Phone: 847-925-7492
  • Fax:
Mailing address:
  • Phone: 847-869-1500
  • Fax: 847-869-1515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209-024781
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number209-024781
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: