Individual
CARA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
155 E BRUSH HILL RD, ELMHURST, IL 60126-5658
(331) 221-3007
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
28230650A
IN
363L00000X
Nurse Practitioner
Primary
209034998
IL
363L00000X
Nurse Practitioner
LM-0010193
DE
363LN0000X
Neonatal Nurse Practitioner
71011304A
IN
363LN0000X
Neonatal Nurse Practitioner
LM-0010193
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300052729
—
IN
Enumeration date
05/06/2021
Last updated
04/20/2026
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