MEDICARE: DR. LESTER B. CHERNICK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics		IL

General Provider Information

NPI Number	:	1144393919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESTER B. CHERNICK DDS

Provider Business Mailing Address
First Line	:	845 N MICHIGAN AVE STE 921E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2213
Country	:	US
Telephone Number	:	312-751-0026
Fax Number	:	312-751-0241

Provider Business Practice Location Address
First Line	:	845 N MICHIGAN AVE STE 921E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2213
Country	:	US
Telephone Number	:	312-751-0026
Fax Number	:	312-751-0241

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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