Provider Demographics
NPI:1790871382
Name:PERRY, GAYLN V (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLN
Middle Name:V
Last Name:PERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-2694
Mailing Address - Fax:844-231-8913
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED ALLERGY/IMMUNO/PULMO
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2694
Practice Address - Fax:844-231-8913
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1P39208000000X, 2080P0214X, 2080P0214X
KS04-259702080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204657803Medicaid
KS635550OtherFIRSTGUARD
MO204657803Medicaid
MO25721014OtherBCBS KC
KS100336150AMedicaid
KS0117467AMedicare PIN
MO25721014OtherBCBS KC