MEDICARE: PAMELA WARNICK M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036-080937	IL
2	207RI0200X	Infectious Disease Physician	036-080937	IL

General Provider Information

NPI Number	:	1013920156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA WARNICK M.D.

Provider Business Mailing Address
First Line	:	2311 W 22ND ST
Second Line	:	SUITE 202
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1460 N HALSTED ST
Second Line	:	SUITE 401
City	:	CHICAGO
State	:	IL
Zip	:	60642-2605
Country	:	US
Telephone Number	:	773-880-0320
Fax Number	:

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

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	05/22/2012

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