Provider Demographics
NPI:1003587049
Name:CERNIAK, GERARD DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:DENNIS
Last Name:CERNIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 TIMBERLINE CT
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-4852
Mailing Address - Country:US
Mailing Address - Phone:815-744-7507
Mailing Address - Fax:
Practice Address - Street 1:208 TIMBERLINE CT.
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-4852
Practice Address - Country:US
Practice Address - Phone:815-744-7507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-46439207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine