Provider Demographics
NPI:1922273572
Name:GAGNON, GAIL (DO)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:GAGNON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1250 S GROVE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5091
Mailing Address - Country:US
Mailing Address - Phone:312-919-1878
Mailing Address - Fax:312-264-0532
Practice Address - Street 1:1250 S GROVE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5091
Practice Address - Country:US
Practice Address - Phone:312-919-1878
Practice Address - Fax:312-264-0532
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.117205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine