Individual provider Active NPI

June Park, M.D.

  • Dermatology Physician
  • Naperville, IL
National Provider Identifier
1285088302
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.156389 Issued in IL
Practice address
263 Shuman Blvd Ste 125
Naperville, IL 60563-1266
Phone
(847) 381-8899
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 036.156389 IL
MOHS-Micrographic Surgery Physician 207ND0101X 1285088302 IL
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 036.156389 IL Primary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 1285088302 IL

Addresses

Primary practice location

263 Shuman Blvd Ste 125
Naperville, IL 60563-1266

Mailing address

263 Shuman Blvd Ste 125
Naperville, IL 60563-1266

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address jpark@directaddress.net
FHIR URL https://select.nextech-api.com/api
Direct Messaging Address jpark321474@direct.myadvocateaurora.org
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210729002886 IL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 3173856846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Derick Dermatology PLLCGroup PAC ID 1557366796, 65 clinicians

Practice addresses (Care Compare)

1600 N Randall Rd
Suite 400
Elgin, IL 60123-7805
Phone (847) 381-8899

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision125
Removal of skin lesions144
Removal of skin cancer437
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.156389ILMDMOHS-Micrographic Surgery Physician
1285088302ILMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derick Dermatology, PLLC Single Specialty Current Accepting new patients
Derick Dermatology, PLLC Single Specialty CurrentSince Sep 7, 2021 Accepting new patients
Derick Dermatology, PLLC Single Specialty CurrentSince Sep 7, 2021 Accepting new patients
Derick Dermatology, PLLC Single Specialty Past Accepting new patients

Locations

85 W Algonquin Rd
Ste 220
Arlington Heights, IL 60005
Phone (866) 337-4251

1531 S Grove Ave
Unit 101
Barrington, IL 60010

820 W Bartlett Rd
Bartlett, IL 60103

329 Remington Blvd
Ste 225
Bolingbrook, IL 60440
Phone (630) 633-1000

750 W Lake Cook Rd
Ste 270
Buffalo Grove, IL 60089

805 Village Center Dr
Burr Ridge, IL 60527

8501 W Higgins Rd
Ste 100
Chicago, IL 60631

525 E Congress Pkwy
Ste 200
Crystal Lake, IL 60014

1600 N Randall Rd
Ste 400
Elgin, IL 60123

230 Commons Dr
Geneva, IL 60134

950 Technology Way
Ste 150
Libertyville, IL 60048
Phone (847) 926-0106

1025 Red Oak Ln
Ste 250
Lindenhurst, IL 60046

353 Bank Dr
Ste 400
McHenry, IL 60050

263 Shuman Blvd
Ste 125
Naperville, IL 60563

1900 Spring Rd
Ste 210
Oak Brook, IL 60523

1147 South Blvd
Oak Park, IL 60302

14225 S 95th Ave
Ste 418
Orland Park, IL 60462

12736 S Route 59
Unit 102
Plainfield, IL 60585

Interoperability endpoints

  • Direct secure messaging: jpark@directaddress.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1285088302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 SHUMAN BLVD STE 125",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631266",
            "fax_number": "847-381-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 SHUMAN BLVD STE 125",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631266",
            "telephone_number": "847-381-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036.156389",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "1285088302",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.156389",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "1285088302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpark@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Derick Dermatology",
            "address_1": "263 Shuman Blvd Ste 125",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605631266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://select.nextech-api.com/api",
            "affiliation": "N",
            "endpointDescription": "Derick Dermatology",
            "address_1": "263 Shuman Blvd Ste 125",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605631266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpark321474@direct.myadvocateaurora.org",
            "affiliation": "N",
            "endpointDescription": "Advocate Good Shepherd",
            "address_1": "450 W Highway 22",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600101919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "Advocate Good Shepherd",
            "address_1": "450 W Highway 22",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600101919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.