| Organization Name: | JERRY P GORE CENTER FOR HOLISTIC MEDICINE LLC |
| NPI Number: | 1376653725 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY P GORE (GENERAL MEDICINE AND PSYCHIATRY) |
| Mailing Address: | 240 Saunders Rd Riverwoods |
| State: | IL US |
| Postal Code: | 600153835 |
| Phone Number: | 8472361701 |
| Fax Number: | 8472361705 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 05/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 180004714 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |