Jenny Park, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010835 Issued in IL

Practice address

1 Oakbrook Center
Oak Brook, IL 60523

Phone

(630) 368-1101

Fax

(630) 368-1095

NPI assigned

Sep 2, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Good Vision Optometry, LLC

  • Optometrist
  • Oak Brook, IL
  • NPI 1033585252
  Authorized official Same address or phone

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1184857401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAKBROOK CENTER",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKBROOK CENTER",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "630-368-1101",
            "fax_number": "630-368-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60113929",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Emmanuel Paniotte, M.D.
• George S. Panos, D.D.S.
• Vasilios S. Panos, DDS
• Sophia Papageorge-Karvelas, LCPC
• Peter Papagiannopoulos, M.D.
• Meejung Jane Park, P.T.
• Parungao Plastic Surgery, SC
• Anna Pasteris, PT
• Amitkumar Pravinkumar Patel, DMD
• Dhruvi Patel

• Optometrist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.