Individual
AMBER GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
89 CEDAR AVE, LAKE VILLA, IL 60046-8411
(847) 265-7300
(847) 265-7301
Mailing address
PO BOX 764, 137 CEDAR AVE, LAKE VILLA, IL 60046-0764
(847) 265-7300
(847) 265-7301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070018105
IL
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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