Quentin Gin Park, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009672 Issued in IL

Practice address

1250 W Lake St Ste 19C
Addison, IL 60101-5744

Phone

(630) 543-0607

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Eye Care Center, LTD.Group PAC ID 0143347047, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Eye Care Center, LTD.

  • Eyewear Supplier
  • Burbank, IL
  • NPI 1144325358

  Optometrist

  Medicare reassignment Care Compare group NPD
• Albina Optometric

  • Optometrist
  • Burbank, IL
  • NPI 1619475852
  NPD (past)
• Bill M. Park

  dba Park Family Eye Care

  • Optometrist
  • North Aurora, IL
  • NPI 1295725950
  NPD (past)
• L.Z. Paczkowski O.D., P.C.

  dba Hinsdale Lake Optics

  • Optometrist
  • Willowbrook, IL
  • NPI 1720260847
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1003830340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST STE 19C",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-543-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W LAKE ST STE 19C",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015744",
            "telephone_number": "630-543-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "QUENTIN",
        "middle_name": "GIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "4584027",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "363187524",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PIN",
            "identifier": "363187524",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "363187524",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "K11567",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pagel Edward Palmer Jr., LMFT
• Nicole Rose Palmer, LCSW
• Sandeep Kaur Pandher, FNP
• Irene Panos
• Utpal Paul Parekh, MD
• Jennifer Paschos, M.D.
• Jennifer Passalaqua, M.S. CCC-SLP
• Dilip B Patel, ARDMS (RDMS, RVT)
• Jignasa Patel, D.C
• Krunal Patel, MD

• Optometrist in Addison, IL
• Providers in Addison, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.