Bill M. Park

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007008 Issued in IL

Legal business name

BILL M. PARK

Practice address

9 S Lincolnway
North Aurora, IL 60542-1608

Phone

(630) 844-2500

Fax

(630) 844-2599

NPI assigned

Oct 25, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Bill M Park, OD

Title

Owner

Phone

(630) 844-2500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Park Family Eye Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Lionel Harris, O.D.

  • Optometrist
  • North Aurora, IL
  • NPI 1194031484
  NPD (past)
• Lena G Park, O.D.

  • Optometrist
  • North Aurora, IL
  • NPI 1275568073
  NPD (past)
• Quentin Gin Park, OD

  • Optometrist
  • Addison, IL
  • NPI 1003830340
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1295725950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 S LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421608",
            "telephone_number": "630-844-2500",
            "fax_number": "630-844-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 S LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421608",
            "telephone_number": "630-844-2500",
            "fax_number": "630-844-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILL M. PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-844-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "4584027",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DG2164",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in North Aurora, IL
• Providers in North Aurora, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.