Individual
JOHN JOOHUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1907 W SPRINGFIELD AVE STE B, CHAMPAIGN, IL 61821-3098
(217) 530-0220
Mailing address
1907 W SPRINGFIELD AVE STE B, CHAMPAIGN, IL 61821-3098
(217) 530-0220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209030497
IL
363LF0000X
Family Nurse Practitioner
Primary
209030497
IL
Other
Enumeration date
09/12/2024
Last updated
01/30/2025
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