Dr Tenore's Fountain of Youth, Corp
NPI #1306181540 in Highland Park, Illinois
Provider Information
- NPI Number
- 1306181540
- Entity Type
- Organization
- Organization Name
- Dr Tenore's Fountain of Youth, Corp
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DR TENORE'S FOUNTAIN OF YOUTH, CORP
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 28, 2012
- Last Updated
- Mar 12, 2013
Practice Location
- Address
- 806 CENTRAL AVE STE 203
- City
- Highland Park
- State
- Illinois
- ZIP Code
- 60035-5613
- Phone
- (847) 681-8821
Authorized Official
- Name
- JOSIE TENORE, M.D.
- Title
- OWNER
- Phone
- (847) 681-8821
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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