Provider Demographics
NPI:1043567589
Name:KERGER, DANIELLE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ANN
Last Name:KERGER
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 1:4445 W 95TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-7220
Mailing Address - Country:US
Mailing Address - Phone:708-423-0940
Mailing Address - Fax:708-423-0980
Practice Address - Street 1:9101 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-1804
Practice Address - Country:US
Practice Address - Phone:708-423-0940
Practice Address - Fax:708-423-0980
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-0291561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice