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Contact Information

MARK J GAGNON, DPM
7355 ARCHER AVE
UNIT D
SUMMIT, IL60501-1225
 Phone: 773-229-8200
 Fax: 773-229-9752
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MARK J GAGNON · (Male)

NPI Number 1043261282
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/12/2006
Last updated 12/22/2021 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 016004840
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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