Individual
DORI LEE ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18409 COWING CT, HOMEWOOD, IL 60430-3334
(217) 454-2985
Mailing address
18409 COWING CT, HOMEWOOD, IL 60430-3334
(217) 454-2985
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
IL
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
11/01/2024
Last updated
11/03/2024
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