Organization
SUSAN K. PARK O.D, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN K TSENG O.D. (PRESIDENT)
(773) 303-8279
Entity
Organization
Contact information
Practice address
9928 S WESTERN AVE, CHICAGO, IL 60643-1831
(773) 303-8279
Mailing address
9928 S WESTERN AVE, CHICAGO, IL 60643-1831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009987
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009987
—
IL
Enumeration date
04/17/2009
Last updated
01/08/2015
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