Provider Demographics
NPI:1316233703
Name:ZERKLE, KAREN (DMD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ZERKLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2809 MANSION RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711
Mailing Address - Country:US
Mailing Address - Phone:217-697-5190
Mailing Address - Fax:217-483-7190
Practice Address - Street 1:2809 MANSION RD
Practice Address - Street 2:SUITE D
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711
Practice Address - Country:US
Practice Address - Phone:217-788-2300
Practice Address - Fax:217-788-2342
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL283331223G0001X
IL019.0283331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice