Amber Gore, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070018105 Issued in IL

Practice address

89 Cedar Ave
Lake Villa, IL 60046-8411

Phone

(847) 265-7300

Fax

(847) 265-7301

NPI assigned

Sep 10, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Birth to Three & Beyond Pediatric Therapies, LLC

  dba The Therapy Tree, LLC

  • Professional Counselor
  • Lake Villa, IL
  • NPI 1063955847
  NPD (past)
• The Therapy Tree D.B.a. Birth to Three & Beyond Pediatric Therapies

  • Speech-Language Pathologist
  • Lake Villa, IL
  • NPI 1710047964
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1245547363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 764",
            "address_2": "137 CEDAR AVE",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600460764",
            "telephone_number": "847-265-7300",
            "fax_number": "847-265-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 CEDAR AVE",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600468411",
            "telephone_number": "847-265-7300",
            "fax_number": "847-265-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "AMBER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gateway Foundation, Inc.
• Gateway Professional Services, PC
• Gary R. Gehrke, RPH.
• Claudelle Renee Glasgow, PSY.D.
• Daniel Aron Goldberg, PSY.D.
• Georgette Grady
• Granting Grace Counseling Services, PLLC
• David Stephen Gray, LCPC
• Jaclyn Patrice Guerriero, PSYD
• Mary Elizabeth Hackel, PT

• Physical Therapist in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.