MEDICARE: MS. TATIA M GORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant		IL

General Provider Information

NPI Number	:	1134307804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TATIA M GORE

Provider Business Mailing Address
First Line	:	4850 S LAKE PARK AVE APT 1708B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2073
Country	:	US
Telephone Number	:	773-368-8333
Fax Number	:	773-538-4536

Provider Business Practice Location Address
First Line	:	4850 S LAKE PARK AVE APT 1708B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2073
Country	:	US
Telephone Number	:	773-368-8333
Fax Number	:	773-538-4536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	03/24/2008

Similar Medicare Providers

1093987638 — KIDZ BIZ EARLY INTERVENTION
Practice Location Address:

4850 S LAKE PARK AVE APT 1708B
CHICAGO, IL
60615-2073

Practice Phone: 773-368-8333
Practice Fax: 773-538-4536

1093119521 — 3 H CARE INC.
Practice Location Address:

4850 S LAKE PARK AVE APT 1710
CHICAGO, IL
60615-2073

Practice Phone: 773-548-4387
Practice Fax:

1487630364 — JOHN G LATALL MD
Practice Location Address:

2073 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-665-4016
Practice Fax: 773-360-6200

1922025865 — SUZETTE LUGO-MEDINA M.D.
Practice Location Address:

358 E CHICAGO ST STE 204E
COLDWATER, MI
49036-2073

Practice Phone: 517-617-9888
Practice Fax:

1538457759 — MS. KINZIE G. SHARP PA-C
Practice Location Address:

2073 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-665-4106
Practice Fax: 773-360-6200

1134485055 — JOHN G LATALL MD SC
Practice Location Address:

2073 N CLYBOURN AVE
CHICAGO, IL
60614-4003

Practice Phone: 773-665-4016
Practice Fax: 773-360-6200

Directions to “ MS. TATIA M GORE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.