Organization
JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC
Active
Other names
CENTER FOR HOLISTIC MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY P GORE M.D. (GENERAL MEDICINE AND PSYCHIATRY)
(847) 236-1701
Entity
Organization
Contact information
Practice address
240 SAUNDERS RD, RIVERWOODS, IL 60015-3835
(847) 236-1701
(847) 236-1705
Mailing address
240 SAUNDERS RD, RIVERWOODS, IL 60015-3835
(847) 236-1701
(847) 236-1705
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180004714
IL
104100000X
Social Worker
149003629
IL
111N00000X
Chiropractor
038010402
MN
174400000X
Specialist
181000325
IL
207R00000X
Internal Medicine Physician
03659329
IL
2084P0800X
Psychiatry Physician
036053622
IL
208D00000X
General Practice Physician
Primary
036053622
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00004927712
DR. DAVIS BC/BS
IL
01
—
0004927712
ALISA COURTNEY LCPC BC/BS
IL
01
—
0004932196
BC/BS
IL
05
—
038010402
—
IL
Enumeration date
08/30/2006
Last updated
05/16/2012
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