Individual
SANGTAE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9711 SKOKIE BLVD, STE H, SKOKIE, IL 60077-1384
(847) 676-2400
(847) 676-2485
Mailing address
9711 SKOKIE BLVD, STE H, SKOKIE, IL 60077-1384
(847) 676-2400
(847) 676-2485
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036119572
IL
208800000X
Urology Physician
M0855
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174078901
—
TX
Enumeration date
03/18/2006
Last updated
04/20/2026
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