Individual
DR. QUENTIN GIN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1250 W LAKE ST STE 19C, ADDISON, IL 60101-5744
(630) 543-0607
Mailing address
1250 W LAKE ST STE 19C, ADDISON, IL 60101-5744
(630) 543-0607
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009672
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363187524
CIGNA
IL
01
—
4584027
BCBS PIN
IL
01
—
K11567
MEDICARE PROVIDER NUMBER
IL
Enumeration date
07/27/2006
Last updated
02/16/2025
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