Provider Demographics
NPI:1033244967
Name:KEARNEY, MICHELLE MAUREEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MAUREEN
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 W BUTTERFIELD RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5000
Mailing Address - Country:US
Mailing Address - Phone:630-834-2270
Mailing Address - Fax:630-834-2275
Practice Address - Street 1:360 W BUTTERFIELD RD STE 210
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5000
Practice Address - Country:US
Practice Address - Phone:630-834-2270
Practice Address - Fax:630-834-2275
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019024826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist