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Individual
DR. WILLIAM C. PARK
Active
Individual
DR. WILLIAM C. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036.121758
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121758
—
IL
05
—
362765923
—
IL
01
—
542440001
WPS PROVIDER NUMBER
IL
01
—
CC2168
RR MC GROUP
IL
01
—
P00819332
RR MEDICARE
—
Enumeration date
08/29/2008
Last updated
08/12/2024
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