Individual
DR. CAROL A GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 GATEWAY DR STE 100, SYCAMORE, IL 60178-3192
(815) 217-3252
(815) 756-4941
Mailing address
1850 GATEWAY DR STE 100, SYCAMORE, IL 60178-3192
(815) 217-3252
(815) 756-4941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0104282A
IN
207P00000X
Emergency Medicine Physician
Primary
036088146
IL
207P00000X
Emergency Medicine Physician
37019-20
WI
207P00000X
Emergency Medicine Physician
625-320
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000223688
ANTHEM BCBS
IN
01
—
036088146
STATE LICENSE
IL
05
—
036088146
—
IL
05
—
200282780
—
IN
01
—
90001082
BCBS
IL
01
—
930118930
MEDICARE RAILROAD
IN
01
—
IN0002292
TRICARE
IN
Enumeration date
01/24/2006
Last updated
01/09/2023
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