Individual
CHANSEUL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9777 N GREENWOOD AVE, NILES, IL 60714
(847) 967-7000
Mailing address
2080 HASSELL RD APT 302, HOFFMAN ESTATES, IL 60169-6334
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008362
IL
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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