Provider Demographics
NPI:1932233020
Name:POKORNY, GAIL LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:LYNN
Last Name:POKORNY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 3 OAKS RD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-6127
Mailing Address - Country:US
Mailing Address - Phone:847-516-8338
Mailing Address - Fax:
Practice Address - Street 1:2615 3 OAKS RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-6127
Practice Address - Country:US
Practice Address - Phone:847-516-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice