Chanseul Park

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.008362 Issued in IL

Practice address

9777 N Greenwood Ave
Niles, IL 60714

Phone

(847) 967-7000

NPI assigned

Sep 21, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1194209551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 HASSELL RD APT 302",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601696334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 N GREENWOOD AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "60714",
            "telephone_number": "847-967-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHANSEUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.008362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijeta Reddy Pamudurthy, D.O.
• Riddhi Panchal
• Paperclip Health
• Park Ridge C C School Dist 64
• Chang Park, D.C.
• Jamie Y Park, D.D.S
• Paul Park, MD
• Zoon H Park, PHARMD
• Alla Pasman, O.D.
• Jharna Ashwin Pastagia, DPT

• Physical Therapy Assistant in Niles, IL
• Providers in Niles, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.