Dr Tenore'S Fountain of Youth, Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DR TENORE'S FOUNTAIN OF YOUTH, CORP

Practice address

806 Central Ave Ste 203
Highland Park, IL 60035-5613

Phone

(847) 681-8821

NPI assigned

Nov 28, 2012

Organization subpart

Yes

Parent organization

DR TENORE'S FOUNTAIN OF YOUTH, CORPAs reported in NPPES

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

Authorized official

Name

Josie Tenore, M.D.

Title

Owner

Phone

(847) 681-8821

Specialties & licenses 1

Addresses

Other names 1

• FreshSkin Doing business as

Part of

Fresh Skin

Locations

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1306181540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE STE 203",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE STE 203",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613",
            "telephone_number": "847-681-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TENORE'S FOUNTAIN OF YOUTH, CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR TENORE'S FOUNTAIN OF YOUTH, CORP",
        "enumeration_date": "2012-11-28",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "TENORE",
        "authorized_official_first_name": "JOSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-681-8821",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FreshSkin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Marie Doppenberg, MD
• Kelly Dougherty, M.S., CCC-SLP
• Dr Barbara Hurwitz
• Dr Brian M Weinerg DMD LTD
• Dr Michael S Maling LTD
• Dr. Bradley T. Friel, P.C.
• Dr.S Schreiber and Fenchel, LTD
• Leon Dragon, MD
• Caroline Dreifuss
• Marie Dreyer

• Family Medicine Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.