Mark James Gagnon, DPM Valid NPI

Individual provider · Podiatrist · Summit, IL

NPI

1043261282

Type

Individual (Type 1)

Primary specialty

Podiatrist

Specialty group

Podiatric Medicine & Surgery Service Providers

Taxonomy code

213E00000X

License number

016004840 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-05-12

Last updated

2021-12-22