Jerry P Gore Center for Holistic Medicine LLC

Organization Active NPI General Practice Physician · Riverwoods, IL

NPI 1376653725 · NPPES record last updated May 16, 2012

Key facts

NPI
1376653725
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
License
036053622 (IL)
Legal business name
JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC
Practice address
240 Saunders Rd
Riverwoods, IL 60015-3835
Phone
(847) 236-1701
Fax
(847) 236-1705
NPI assigned
Aug 30, 2006
Organization subpart
No

Authorized official

Name
Dr. Jerry P Gore, M.D.
Title
General Medicine and Psychiatry
Phone
(847) 236-1701

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

240 Saunders Rd
Riverwoods, IL 60015
Phone (847) 236-1701

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
101Y00000X 180004714 IL
Social Worker
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
104100000X 149003629 IL
Chiropractor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
111N00000X 038010402 MN
Specialist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
174400000X 181000325 IL
Internal Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207R00000X 03659329 IL
Psychiatry Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2084P0800X 036053622 IL
General Practice Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
208D00000X 036053622 IL Yes

Addresses

Primary practice location

240 Saunders Rd
Riverwoods, IL 60015-3835

Mailing address

240 Saunders Rd
Riverwoods, IL 60015-3835
Phone (847) 236-1701

Other identifiers

IdentifierTypeStateIssuer
0004932196OtherILBC/BS
0004927712OtherILALISA COURTNEY LCPC BC/BS
0004927712OtherILCAROL GORE LCSW BC/BS
038010402MedicaidIL
00004927712OtherILDR. DAVIS BC/BS

Other names

  • CENTER FOR HOLISTIC MEDICINE Doing business as

Other providers in Riverwoods, IL

All providers in Riverwoods, IL · General Practice Physician in Illinois

Sources for this page

Verify at the official NPI Registry.