Provider Demographics
NPI:1245448430
Name:KARL EDWARD FELKER, D.M.D. , P.C.
Entity type:Organization
Organization Name:KARL EDWARD FELKER, D.M.D. , P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FELKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:815-625-0346
Mailing Address - Street 1:303 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-1265
Mailing Address - Country:US
Mailing Address - Phone:815-625-0346
Mailing Address - Fax:815-625-0384
Practice Address - Street 1:303 W 2ND ST
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1265
Practice Address - Country:US
Practice Address - Phone:815-625-0346
Practice Address - Fax:815-625-0384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190165581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty