MEDICARE: GAIL GAGNON D.O.

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
1	207Q00000X	Family Medicine Physician	036.117205	IL

General Provider Information

NPI Number	:	1922273572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL GAGNON D.O.

Provider Business Mailing Address
First Line	:	1250 S GROVE AVE
Second Line	:	SUITE 200
City	:	BARRINGTON
State	:	IL
Zip	:	60010-5091
Country	:	US
Telephone Number	:	312-919-1878
Fax Number	:	312-264-0532

Provider Business Practice Location Address
First Line	:	1250 S GROVE AVE
Second Line	:	SUITE 200
City	:	BARRINGTON
State	:	IL
Zip	:	60010-5091
Country	:	US
Telephone Number	:	312-919-1878
Fax Number	:	312-264-0532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	10/16/2012

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Directions to “ GAIL GAGNON D.O.” Practice Location

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