Individual provider Active NPI

Brian M Cerny, PHD

  • Clinical Neuropsychologist
  • Libertyville, IL
National Provider Identifier
1629612106
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071.022486 Issued in IL
Practice address
1850 W Winchester Rd Ste 103
Libertyville, IL 60048-5322
Phone
(224) 707-4321
NPI assigned
Oct 29, 2019
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071.022486 IL Primary

Addresses

Primary practice location

1850 W Winchester Rd Ste 103
Libertyville, IL 60048-5322

Mailing address

1585 N Milwaukee Ave Ste 109
Libertyville, IL 60048-1359

Other practice location 1

1585 N Milwaukee Ave Ste 109
Libertyville, IL 60048-1359
Phone (224) 707-4321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Psychological Services Evaluations PLLC PastSince Apr 6, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1629612106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 N MILWAUKEE AVE STE 109",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 W WINCHESTER RD STE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485322",
            "telephone_number": "224-707-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 N Milwaukee Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600481359",
            "country_code": "US",
            "telephone_number": "224-707-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERNY",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.022486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.