Lydia K Park, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041.507872 Issued in IL

Practice address

3715 Municipal Dr
McHenry, IL 60050-5483

Phone

(815) 759-2306

NPI assigned

Feb 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lydia K Park Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1891551800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAPTAIN JAMES",
            "address_2": "A LOVELL FHCC",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "60064",
            "telephone_number": "224-610-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 MUNICIPAL DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505483",
            "telephone_number": "815-759-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LYDIA",
        "middle_name": "K",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "O41.507872",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.507872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "PARK",
            "middle_name": "K",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jana Parejko
• Brooke Paresi, APRN, CRNA
• Bindi Parikh, MD
• Diana Park, PHARMD.
• Jong Park, PHARM.D., BCPS
• Om Parkash
• Alysa Katelyn Parker
• Molly Parker
• Kaylee Eugenia Partridge
• Rene Sherwin Parungao, MD

• Registered Nurse in McHenry, IL
• Providers in McHenry, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.