Individual
DR. LENA G PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9 S LINCOLNWAY, NORTH AURORA, IL 60542-1608
(630) 844-2500
(630) 844-2599
Mailing address
9 S LINCOLNWAY, NORTH AURORA, IL 60542-1608
(630) 844-2500
(630) 844-2599
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009865
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11683632
CAQH PIN
IL
01
—
363187524
AETNA
IL
01
—
4584027
BCBS PIN
IL
01
—
K28764
MEDICARE PROVIDER NUMBER
IL
Enumeration date
07/11/2006
Last updated
06/25/2008
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