Provider Demographics
NPI:1871932830
Name:ANDERKO, SARAH ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANNE
Last Name:ANDERKO
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 1:5136 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-3617
Mailing Address - Country:US
Mailing Address - Phone:708-867-5000
Mailing Address - Fax:
Practice Address - Street 1:5 LEEDS CT
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-3432
Practice Address - Country:US
Practice Address - Phone:317-966-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-22
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8347122300000X
IL019029488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist