Organization
DR TENORE'S FOUNTAIN OF YOUTH, CORP
Active
Parent organization
DR TENORE'S FOUNTAIN OF YOUTH, CORP
Other names
FreshSkin
Organization subpart
Yes
Provider details
NPI number
Legal business name
DR TENORE'S FOUNTAIN OF YOUTH, CORP
Authorized official
JOSIE TENORE M.D. (OWNER)
(847) 681-8821
Entity
Organization
Contact information
Practice address
806 CENTRAL AVE STE 203, HIGHLAND PARK, IL 60035-5613
(847) 681-8821
Mailing address
806 CENTRAL AVE STE 203, HIGHLAND PARK, IL 60035-5613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
03/12/2013
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