Individual
JEAN L CLORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
221 NE GLEN OAK AVE, 7 WEST, PEORIA, IL 61636-0001
(309) 671-8222
Mailing address
221 NE GLEN OAK AVE, 7 WEST, PEORIA, IL 61636-0001
(309) 671-8222
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008130
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199968
HEALTH ALLIANCE
IL
Enumeration date
05/16/2011
Last updated
01/20/2012
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