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NPI Code Detail

MEDICARE: DR. ROBERT J GORE M.D.

MEDICARE: DR. ROBERT J GORE M.D.
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
1207P00000XEmergency Medicine Physician36114798IL

General Provider Information

NPI Number : 1437113388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT J GORE M.D.
Provider Business Mailing Address
First Line : 3440 S COTTAGE GROVE AVE
Second Line : APT 602
City : CHICAGO
State : IL
Zip : 60616-4140
Country : US
Telephone Number : 312-326-3907
Fax Number :
Provider Business Practice Location Address
First Line : 3440 S COTTAGE GROVE AVE
Second Line : APT 602
City : CHICAGO
State : IL
Zip : 60616-4140
Country : US
Telephone Number : 312-326-3907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2006
Last Update Date : 07/08/2007

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