Individual
DR. DAVID H PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5201 WILLOW SPRINGS RD, SUITE #290, LA GRANGE HIGHLANDS, IL 60525-6537
(708) 579-0018
(708) 579-7571
Mailing address
5201 WILLOW SPRINGS RD, SUITE #290, LA GRANGE HIGHLANDS, IL 60525-6537
(708) 579-0018
(708) 579-7571
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-114009
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
399690
GROUP PTAN
—
01
—
403270
GROUP PTAN
—
Enumeration date
08/05/2006
Last updated
03/25/2021
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