Individual
DR. KEVIN CHANIL PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2161 WINDING STREAM WAY, SUN PRAIRIE, WI 53590-8868
(702) 994-2958
Mailing address
2161 WINDING STREAM WAY, SUN PRAIRIE, WI 53590-8868
(702) 994-2958
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
154140
MA
207R00000X
Internal Medicine Physician
Primary
68021
WI
Other
Enumeration date
07/11/2006
Last updated
07/16/2025
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