Individual
AMANDA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 766-4949
(312) 766-4908
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-158292
IL
207L00000X
Anesthesiology Physician
66631
CT
Other
Enumeration date
06/03/2016
Last updated
12/29/2023
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