John Joohun Park, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209030497 Issued in IL

Practice address

1907 W Springfield Ave Ste B
Champaign, IL 61821-3098

Phone

(217) 530-0220

NPI assigned

Sep 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chambana Urgent Care and Walk in ClinicGroup PAC ID 5395196372, 5 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Chambana Urgent Care and Walk in Clinic

  • Urgent Care Clinic/Center
  • Champaign, IL
  • NPI 1770358871
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Kirby Medical Center

  • Family Medicine Physician
  • Monticello, IL
  • NPI 1386635373
  Medicare reassignment NPD
• Kirby Medical Center

  dba Kirby Rx

  • Community/Retail Pharmacy
  • Monticello, IL
  • NPI 1568074714
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1477389773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W SPRINGFIELD AVE STE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213098",
            "telephone_number": "217-530-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SPRINGFIELD AVE STE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213098",
            "telephone_number": "217-530-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOHN",
        "middle_name": "JOOHUN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "209030497",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Paulas Pantoja, OD
• Mbuyi Christian Panumpabi
• Karla M. Paquin, MHP
• Susan Elizabeth Paradee
• Paradox Champaign Operator LLC (Champaign Living Center)
• Jong T Park, PT, MPT
• Peter Park, RPH
• Summer L Park, APN
• Caleb Steven Parker, HIGH SCHOOL DIPLOMA
• Carol Louise Parker, MA

• Family Nurse Practitioner in Champaign, IL
• Providers in Champaign, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.

Verify at the official NPI Registry.