Individual
JAEOH PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
436 WHITE PINE RD, BUFFALO GROVE, IL 60089-3326
(224) 433-0992
Mailing address
436 WHITE PINE RD, BUFFALO GROVE, IL 60089-3326
(224) 433-0992
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
238853
IL
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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