Provider Demographics
NPI:1376552521
Name:SHORR, GAIL JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:JOYCE
Last Name:SHORR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 HIGHCREST DR
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2358
Mailing Address - Country:US
Mailing Address - Phone:847-251-6096
Mailing Address - Fax:847-251-5124
Practice Address - Street 1:1100 CENTRAL AVE
Practice Address - Street 2:SUITE H
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2666
Practice Address - Country:US
Practice Address - Phone:847-256-6480
Practice Address - Fax:847-256-6482
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics