Individual
JOHN GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2395 LAKE SHORE DR S, GOREVILLE, IL 62939-3167
(224) 316-0402
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209021629
IL
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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