Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | IL |
NPI | 1144393919 |
---|---|
Provider Name | Dr. Lester B. Chernick |
First Address | Chicago, IL 60611-2213 |
Second Address | Chicago, IL 60611-2213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |