Healthcare Provider Details

I. General information

NPI: 1184216707
Provider Name (Legal Business Name): BRIAN CHERNY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N NORTHWEST HWY STE 325
PARK RIDGE IL
60068-6404
US

IV. Provider business mailing address

444 N NORTHWEST HWY STE 325
PARK RIDGE IL
60068-6404
US

V. Phone/Fax

Practice location:
  • Phone: 847-296-6100
  • Fax:
Mailing address:
  • Phone: 847-296-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number021.003540
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: