Healthcare Provider Details

I. General information

NPI: 1154345262
Provider Name (Legal Business Name): JOHN DANIEL WARRINGTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 W. ILES SUITE A
SPRINGFIELD IL
62704-4192
US

IV. Provider business mailing address

2035 W ILES AVE
SPRINGFIELD IL
62704-4192
US

V. Phone/Fax

Practice location:
  • Phone: 217-787-9100
  • Fax: 217-787-6616
Mailing address:
  • Phone: 217-787-9100
  • Fax: 217-787-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038-008361
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: