Individual provider Active NPI

Cara Park, APN-CNP

  • Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1407430408
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209034998 Issued in IL
Practice address
155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone
(331) 221-3007
NPI assigned
May 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X LM-0010193 DE
Nurse Practitioner 363L00000X 209034998 IL Primary
Neonatal Intensive Care Registered Nurse 163WN0002X 28230650A IN
Nurse Practitioner 363L00000X LM-0010193 DE
Neonatal Nurse Practitioner 363LN0000X 71011304A IN

Addresses

Primary practice location

155 E Brush Hill Rd
Elmhurst, IL 60126-5658

Mailing address

707 Cedar St Ste 405
South Bend, IN 46617-2059
Phone (574) 335-8707

Other practice location 1

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Phone (574) 335-4145

Other identifiers 1

IdentifierTypeStateIssuer
300052729MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, DE, IL3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210716001560 IN Practitioner - Nurse Practitioner 0042612764 Reassigns benefits to 1 organization
I20250716000685 DE Practitioner - Nurse Practitioner 0042612764 Reassigns benefits to 2 organizations
I20260421002946 IL Practitioner - Nurse Practitioner 0042612764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28230650AINMDNeonatal Intensive Care Registered Nurse
209034998ILMDNurse Practitioner
LM-0010193DEMDNeonatal Nurse Practitioner
71011304AINMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Apr 24, 2025 Accepting new patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Current Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Apr 24, 2025 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. CurrentSince Jul 14, 2021 Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc Neonatal CurrentSince Jul 14, 2021 Accepting new patients
Bayhealth Medical Center, Inc. Current Accepting new patients
Saint Joseph Regional Medical Center- Plymouth Campus Inc Past Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

707 Cedar St
Ste 200
South Bend, IN 46617
Phone (574) 237-1328

Interoperability endpoints

  • Direct secure messaging: cpark1141805@direct.trinity-health.org

Organizations & group practices 9

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1407430408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CEDAR ST STE 405",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172059",
            "telephone_number": "574-335-8707",
            "fax_number": "574-335-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E BRUSH HILL RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265658",
            "telephone_number": "331-221-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 Holy Cross Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465451469",
            "country_code": "US",
            "telephone_number": "574-335-4145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "CARA",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "DE",
            "license": "LM-0010193",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209034998",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "IN",
            "license": "28230650A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LM-0010193",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "71011304A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300052729",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.