Gore, Jerry P

Gore, Jerry P is an individual health care provider with primary practice located at 240 Saunders Rd , Riverwoods IL 60015-3835. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Gore, Jerry P can be contacted via phone (847) 236-1701.

Contact Information

Primary practice address
240 Saunders Rd Riverwoods IL 60015-3835
Phone: (847) 236-1701
Fax: (847) 236-1705
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X Illinois
Allopathic & Osteopathic Physicians / General Practice 208D00000X Illinois

Profile Details

NPI number 1972695633
LBN Legal business name Gore, Jerry P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Dec 28th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972695633 NPPES
Illinois Other 0004932196 BC/BS

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