Active NPI
Sydney Elizabeth Park, PHD
- Clinical Neuropsychologist
- Milwaukee, WI
National Provider Identifier
1194451047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 5160-57
- Practice address
- 9000 W Wisconsin Ave
Milwaukee, WI 53226-4874 - Phone
- (262) 366-4318
- NPI assigned
- Jul 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 5160-57 | WI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Mailing address
2501 N 55TH St
Milwaukee, WI 53210-2746
Phone (262) 366-4318
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194451047 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5160-57 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1194451047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 N 55TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532102746",
"telephone_number": "262-366-4318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "262-366-4318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SYDNEY",
"middle_name": "ELIZABETH",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-25",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "WI",
"license": "5160-57",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194451047",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.