JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC NPI 1376653725

NPI Information

NPI: 1376653725
Provider Name: JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC

Doing Business As: CENTER FOR HOLISTIC MEDICINE

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
240 SAUNDERS RD
RIVERWOODS, IL
ZIP 60015
Phone: (847) 236-1701
Get Directions

JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC is a general practice in Riverwoods, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC NPI is 1376653725. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Center For Holistic Medicine.

The provider's business location address is:

240 SAUNDERS RD
RIVERWOODS, IL
ZIP 60015-835
Phone: (847) 236-1701
Fax: (847) 236-1705

The provider's authorized official is Jerry P Gore .
The authorized official title is General Medicine And Psychiatry and has the following contact phone number (847) 236-1701.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 5/16/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		180004714	ILLINOIS	No
2	104100000X	Social Worker		149003629	ILLINOIS	No
3	111N00000X	Chiropractor		038010402	MINNESOTA	No
4	2084P0800X	Psychiatry & Neurology	Psychiatry	036053622	ILLINOIS	No
5	207R00000X	Internal Medicine		03659329	ILLINOIS	No
6	174400000X	Specialist		181000325	ILLINOIS	No
7	208D00000X	General Practice		036053622	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0004927712	OTHER	ILLINOIS	CAROL GORE LCSW BC/BS
2	00004927712	OTHER	ILLINOIS	DR. DAVIS BC/BS
3	038010402	MEDICAID	ILLINOIS
4	0004932196	OTHER	ILLINOIS	BC/BS
5	K20013	MEDICARE PIN	ILLINOIS
6	0004927712	OTHER	ILLINOIS	ALISA COURTNEY LCPC BC/BS
7	L66522	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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