Individual provider Active NPI

Jon Karl Warnecke, DC

  • Chiropractor
  • Harvard, IL
National Provider Identifier
1902962681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
30 N Ayer St
Harvard, IL 60033
Phone
(815) 943-9150
Fax
(815) 943-6122
NPI assigned
Dec 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary
Chiropractor 111N00000X 0002048012 WI

Addresses

Primary practice location

30 N Ayer St
Harvard, IL 60033

Mailing address

30 N Ayer St
Harvard, IL 60033
Phone (815) 943-9150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120510000456 IL Practitioner - Chiropractic 4880856749 Reassigns benefits to 1 organization
Practice locations: Harvard, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Ayer Street Chiropractic LLCGroup PAC ID 0840720678, 2 clinicians

Practice addresses (Care Compare)

50 N Ayer St
Harvard, IL 60033-2803
Phone (815) 943-9150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0002048012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ayer Street Chiropractic LLC Chiropractor CurrentSince Jan 11, 2025 Accepting new patients

Locations

50 N Ayer St
Harvard, IL 60033
Phone (815) 575-8510

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902962681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N AYER ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "60033",
            "telephone_number": "815-943-9150",
            "fax_number": "815-943-6122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N AYER ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "60033",
            "telephone_number": "815-943-9150",
            "fax_number": "815-943-6122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNECKE",
        "first_name": "JON",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "0002048012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.