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Individual

MR. GERALD M. BEDORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APN/CNP

Contact information

Practice address
835 S WOLCOTT AVE RM E-144, CHICAGO, IL 60612-3748
(312) 996-7420
(312) 413-8485
Mailing address
835 S WOLCOTT AVE RM E-144, CHICAGO, IL 60612-3748
(312) 996-7420
(312) 413-8485

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.004416
IL
363LG0600X
Gerontology Nurse Practitioner
209.004416
IL

Other

Enumeration date
06/06/2008
Last updated
06/06/2008
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