Active NPI
David H Park, MD
- Surgery Physician
- La Grange Highlands, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036-114009
- Practice address
- 5201 Willow Springs Rd
Suite #290
La Grange Highlands, IL 60525-6537 - Phone
- (708) 579-0018
- Fax
- (708) 579-7571
- NPI assigned
- Aug 5, 2006
- Last updated
- Mar 25, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036-114009 | IL | Primary |
Addresses
Primary practice location
5201 Willow Springs Rd
Suite #290
La Grange Highlands, IL 60525-6537
Mailing address
5201 Willow Springs Rd
Suite #290
La Grange Highlands, IL 60525-6537
Phone (708) 579-0018
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 399690 | Other | GROUP PTAN | |
| 403270 | Other | GROUP PTAN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | david.park.1@380.direct.athenahealth.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000
396 Remington Blvd
Bolingbrook, IL 60440-4311
5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-7044
Hospital & facility affiliations
- Uchicago Medicine Adventhealth Hinsdale
- Uchicago Medicine Adventhealth la Grange
- Uchicago Medicine Adventhealth Bolingbrook
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 43 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 41 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-114009 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Partners,Inc | Current | Accepting new patients | |
| Adventist Health Partners,Inc | Current | Accepting new patients | |
| Adventist Health Partners, Inc. | Current | Accepting new patients | |
| Surgical Practice, LTD | Surgery | Past | Accepting new patients |
| University of Chicago | Past | Accepting new patients | |
| Adventist Health Partners, Inc | Past | Accepting new patients |
Locations
396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301
333 W Chestnut St
Ste 105
Hinsdale, IL 60521
Phone (630) 789-0250
911 N Elm St
Ste 123
Hinsdale, IL 60521
Phone (630) 325-5709
5201 Willow Springs Rd
Ste 290
La Grange Highlands, IL 60525
5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073
Interoperability endpoints
- dpark1239586@adventhealth.direct-ci.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- La Grange, IL
- NPI 1932650496
-
dba Glendale Family Practice
- Family Medicine Physician
- Bloomingdale, IL
- NPI 1043255888
-
dba Family Medicine Center
- Family Medicine Physician
- Woodridge, IL
- NPI 1174568992
-
dba Hinsdale Primary Care
- Family Medicine Physician
- Hinsdale, IL
- NPI 1952339939
-
- Surgery Physician
- Naperville, IL
- NPI 1174622971
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1821048786
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adventhealth Bolingbrook
- General Acute Care Hospital
- Bolingbrook, IL
- NPI 1164530465
-
- General Acute Care Hospital
- Hinsdale, IL
- NPI 1265465439
-
dba Adventhealth la Grange
- General Acute Care Hospital
- La Grange, IL
- NPI 1407889652
-
dba Adventhealth Hinsdale
- Psychiatric Hospital Unit
- Hinsdale, IL
- NPI 1447270780
-
dba Adventhealth la Grange
- Rehabilitation Hospital Unit
- La Grange, IL
- NPI 1588068274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616630400000",
"number": "1326057969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 WILLOW SPRINGS RD",
"address_2": "SUITE #290",
"city": "LA GRANGE HIGHLANDS",
"state": "IL",
"postal_code": "605256537",
"telephone_number": "708-579-0018",
"fax_number": "708-579-7571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 WILLOW SPRINGS RD",
"address_2": "SUITE #290",
"city": "LA GRANGE HIGHLANDS",
"state": "IL",
"postal_code": "605256537",
"telephone_number": "708-579-0018",
"fax_number": "708-579-7571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "DAVID",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2021-03-25",
"certification_date": "2021-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036-114009",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "399690",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "403270",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "david.park.1@380.direct.athenahealth.com",
"affiliation": "N",
"address_1": "5201 Willow Springs Rd",
"address_2": "suite #290",
"city": "LA Grange Highlands",
"state": "IL",
"country_code": "US",
"postal_code": "605256537",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in La Grange Highlands, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.