Provider Demographics
NPI:1083604177
Name:KIRSCHER, DENNIS W (OD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:W
Last Name:KIRSCHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1112 S WASHINGTON ST
Mailing Address - Street 2:STE 214
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7964
Mailing Address - Country:US
Mailing Address - Phone:708-301-2020
Mailing Address - Fax:708-301-0884
Practice Address - Street 1:13231 W 143RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-6638
Practice Address - Country:US
Practice Address - Phone:708-301-2020
Practice Address - Fax:708-301-0884
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-006743152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37316Medicare UPIN
ILL93110Medicare ID - Type Unspecified