Individual provider Active NPI

Richard Park, LMFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1306369160
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1136 S Delano CT W Ste B201
Chicago, IL 60605
Phone
(847) 220-4390
NPI assigned
Jul 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1136 S Delano CT W Ste B201
Chicago, IL 60605

Mailing address

1 Illinois Blvd
Hoffman Estates, IL 60169-3314

Other practice location 1

1 Illinois Blvd
Hoffman Estates, IL 60169
Phone (847) 285-4516

Other practice location 2

1 Illinois Blvd
Hoffman Estates, IL 60169
Phone (847) 285-4516

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

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1306369160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ILLINOIS BLVD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601693314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 S DELANO CT W STE B201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60605",
            "telephone_number": "847-220-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Illinois Blvd",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "60169",
            "country_code": "US",
            "telephone_number": "847-285-4516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Illinois Blvd",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "60169",
            "country_code": "US",
            "telephone_number": "847-285-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "RICHARD",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-24",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.