=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295170454
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARGARET S WARNER PHD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2013
-----------------------------------------------------
Last Update Date | 05/01/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5559 S BLACKSTONE AVE UNIT 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60637-1833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-643-8548
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5559 S BLACKSTONE AVE UNIT 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60637-1833
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-643-8548
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARGARET S. WARNER
-----------------------------------------------------
Credential | PHD.
-----------------------------------------------------
Telephone | 773-896-6719
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 071-002625
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------