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General NPI Number Information
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NPI Number | 1598055808
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Entity Type | Organization
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Legal Business Name | CHERNIAK FAMILY CHIROPRACTIC, PC
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 203 W PRAIRIE ST
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City | MARENGO
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State | IL
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Zip | 60152-2136
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Country | US
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Telephone | 815-568-2815
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Fax | 815-568-9584
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Provider Business Mailing Address
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Address Line | 203 W PRAIRIE ST
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City | MARENGO
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State | IL
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Zip | 60152-2136
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Country | US
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Telephone | 815-568-2815
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Fax | 815-568-9584
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Authorized Official
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Title or Position | OWNER/CHRIOPRACTOR
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Name | DR. DEAN P. CHERNIAK
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Credential | D.C., CCSP
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Telephone | 815-568-2815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 038-008504
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038-008504
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License Number State | IL
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