Active NPI
Kyunghwan Park, D.C.
- Chiropractor
- Des Plains, IL
National Provider Identifier
1275697575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Practice address
- 9820 N Milwaukee Ave
Unit D
Des Plains, IL 60016 - Phone
- (563) 650-0115
- Fax
- (309) 344-9478
- NPI assigned
- Dec 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | IL | Primary |
Addresses
Primary practice location
9820 N Milwaukee Ave
Unit D
Des Plains, IL 60016
Mailing address
PO Box 1345
Galesburg, IL 61402-1345
Phone (563) 650-0115
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275697575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1345",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614021345",
"telephone_number": "563-650-0115",
"fax_number": "309-344-9478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9820 N MILWAUKEE AVE",
"address_2": "UNIT D",
"city": "DES PLAINS",
"state": "IL",
"postal_code": "60016",
"telephone_number": "563-650-0115",
"fax_number": "309-344-9478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "KYUNGHWAN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plains, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.