Provider Demographics
NPI:1689262156
Name:CERNEK, TREVOR DEAN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:DEAN
Last Name:CERNEK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4003
Mailing Address - Country:US
Mailing Address - Phone:847-345-2250
Mailing Address - Fax:
Practice Address - Street 1:7150 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2225
Practice Address - Country:US
Practice Address - Phone:773-229-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051303712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist