Individual
DR. JOANNE GAIL PARKS
Active
Individual
DR. JOANNE GAIL PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036086270
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0490572803
BLUE CROSS BLUE SHIELD
IL
01
—
364030461
FEIN
IL
Enumeration date
02/13/2007
Last updated
10/03/2013
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