Individual
CHI SOO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
70 E LAKE ST SIDE 2, CHICAGO, IL 60601-5913
(312) 796-9507
Mailing address
2851 S KING DR APT 1308, CHICAGO, IL 60616-2937
(951) 217-4934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/25/2021
Last updated
02/14/2023
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