Individual
MICHAEL GILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
100 DEERPATH, CHARLESTON, IL 61920-9427
(217) 345-2727
(217) 345-2781
Mailing address
211 E FAYETTE AVE, EFFINGHAM, IL 62401-3614
(217) 343-8721
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
—
IL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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