MEDICARE: RODNEY EARL YERGLER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1831224963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY EARL YERGLER DDS

Provider Business Mailing Address
First Line	:	201 WALL STREET
Second Line	:	PO BOX 397
City	:	CRESCENT CITY
State	:	IL
Zip	:	60928-0397
Country	:	US
Telephone Number	:	815-683-2570
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 A MAIN STREET
Second Line	:
City	:	CRESCENT CITY
State	:	IL
Zip	:	60928-0089
Country	:	US
Telephone Number	:	815-683-2114
Fax Number	:	815-683-2143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/08/2007

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