Organization
JESSE K. PARK MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE KITAI PARK MD (MEDICAL DOCTOR)
(630) 325-8681
Entity
Organization
Contact information
Practice address
100 TOWER DR, SUITE 105, BURR RIDGE, IL 60527-5777
(630) 325-8681
(630) 325-3936
Mailing address
100 TOWER DR, SUITE 105, BURR RIDGE, IL 60527-5777
(630) 325-8681
(630) 325-3936
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036-080235
IL
Other
Enumeration date
11/28/2007
Last updated
02/28/2013
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