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NPI Code Detail

MEDICARE: DR. MITCHELL L WARREN M.D.

MEDICARE:  DR. MITCHELL L WARREN  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
1207W00000XOphthalmology Physician036093327IL
2207W00000XOphthalmology Physician036-093327IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1180039248OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376543041
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MITCHELL L WARREN M.D.
Provider Business Mailing Address
First Line : 740 WAUKEGAN RD
Second Line : SUITE 360
City : DEERFIELD
State : IL
Zip : 60015-4374
Country : US
Telephone Number : 847-945-6770
Fax Number : 847-945-3159
Provider Business Practice Location Address
First Line : 740 WAUKEGAN RD
Second Line : SUITE 360
City : DEERFIELD
State : IL
Zip : 60015
Country : US
Telephone Number : 847-945-6770
Fax Number : 847-945-3159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 09/04/2018

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Directions to “ DR. MITCHELL L WARREN M.D.” Practice Location

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