Provider Demographics
NPI:1497804645
Name:CHERNIAK, DEAN P (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:P
Last Name:CHERNIAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 S JEFFERSON ST
Mailing Address - Street 2:APT 2N
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3454
Mailing Address - Country:US
Mailing Address - Phone:815-426-0006
Mailing Address - Fax:
Practice Address - Street 1:216 S JEFFERSON ST
Practice Address - Street 2:APT 2N
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3454
Practice Address - Country:US
Practice Address - Phone:815-426-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
589810Medicare ID - Type Unspecified
U81238Medicare UPIN
IL04922461OtherBCBS