MEDICARE: DILLON T. WARNECKE APN-CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	209035705	IL
2	163W00000X	Registered Nurse	041.482251	IL

General Provider Information

NPI Number	:	1013749290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLON T. WARNECKE APN-CRNA

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE
Second Line	:	SUITE 1223
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-618-7140
Fax Number	:	847-618-0228

Provider Business Practice Location Address
First Line	:	800 W. CENTRAL RD.
Second Line	:	DEPARTMENT OF ANESTHESIA
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2349
Country	:	US
Telephone Number	:	847-618-7140
Fax Number	:	847-618-0228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2024
Last Update Date	:	06/04/2026

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