Individual
DR. ANNA J PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2015 N MAIN ST, WHEATON, IL 60187-3152
(630) 668-8250
(630) 668-8916
Mailing address
2015 N MAIN ST, WHEATON, IL 60187-3152
(630) 668-8250
(630) 668-8916
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036-107883
IL
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
036-107883
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107883
—
IL
01
—
P00132918
RR MEDICARE
IL
Enumeration date
10/13/2005
Last updated
08/26/2024
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