Strivemd Wellness & Ketamine PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

STRIVEMD WELLNESS & KETAMINE PLLC

Practice address

8707 Skokie Blvd Ste 307
Skokie, IL 60077-2281

Phone

(847) 213-0990

NPI assigned

Dec 11, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Danny Park, MDNPI 1811148786

Title

MD / Partner

Phone

(419) 509-3726

Specialties & licenses 1

Addresses

Practitioners 1

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

• Danny S Park, MD

  • Neurology Physician
  • Chicago, IL
  • NPI 1811148786
  NPD Authorized official

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1336735562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD STE 307",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772281",
            "telephone_number": "847-213-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD STE 307",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772281",
            "telephone_number": "847-213-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRIVEMD WELLNESS & KETAMINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "MD / PARTNER",
        "authorized_official_telephone_number": "419-509-3726",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael E. Stone, PSY.D.
• Allison Eckel Stoner, M.S., OTR/L
• Kimberly Stover
• Deborah Strauss, LCSW
• Rebecca Strauss, L.C.S.W.
• Stuart P. Sondheimer, M.D., S.C.
• Erica Sturtevant, PA-C
• Arlette Cristina Suarez, RN
• Suburban Home Respiratory Care Service Inc
• Alyse C Suffield, BBCA

• Pain Medicine (Anesthesiology) Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.