Individual
EUN JO PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612
(312) 996-4008
Mailing address
1173 GREENBRIAR LANE, NORTHBROOK, IL 60062
(773) 440-4040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.447466
IL
363LF0000X
Family Nurse Practitioner
Primary
209028858
IL
Other
Enumeration date
05/08/2023
Last updated
02/16/2024
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