Provider Demographics
NPI:1356397897
Name:TENORE, JOSIE LEIGH (MD)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:LEIGH
Last Name:TENORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:806 CENTRAL AVE
Mailing Address - Street 2:203
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5613
Mailing Address - Country:US
Mailing Address - Phone:847-681-8821
Mailing Address - Fax:847-681-8922
Practice Address - Street 1:806 CENTRAL AVE
Practice Address - Street 2:203
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5613
Practice Address - Country:US
Practice Address - Phone:847-681-8821
Practice Address - Fax:847-681-8922
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2013-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036099015207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F73368Medicare UPIN