# STRIVEMD WELLNESS & KETAMINE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336735562
- **Authorized official:** DR. DANNY PARK MD (MD / PARTNER)
- **Authorized official phone:** (419) 509-3726

## Contact information

- **Practice address:** 8707 SKOKIE BLVD STE 307, SKOKIE, IL 60077-2281
- **Practice address phone:** (847) 213-0990
- **Mailing address:** 8707 SKOKIE BLVD STE 307, SKOKIE, IL 60077-2281
- **Mailing address phone:** (847) 213-0990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2020
- **Last updated:** 12/11/2020