Provider Demographics
NPI:1659432367
Name:GERMAN, NADIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:GERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:CHERNYAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1275 E BELVIDERE RD
Mailing Address - Street 2:STE 202
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030
Mailing Address - Country:US
Mailing Address - Phone:847-548-5750
Mailing Address - Fax:847-548-5752
Practice Address - Street 1:1275 E BELVIDERE RD
Practice Address - Street 2:STE 202
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030
Practice Address - Country:US
Practice Address - Phone:847-548-5750
Practice Address - Fax:847-548-5752
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19026228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1005647Medicaid