Individual provider Active NPI

Bill M Park, O.D.

  • Optometrist
  • North Aurora, IL
National Provider Identifier
1912902115
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046 007008 Issued in IL
Practice address
9 S Lincolnway
North Aurora, IL 60542-1608
Phone
(638) 844-2500
Fax
(630) 844-2599
NPI assigned
Jun 15, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046 007008 IL Primary

Addresses

Primary practice location

9 S Lincolnway
North Aurora, IL 60542-1608

Mailing address

9 S Lincolnway
North Aurora, IL 60542-1608
Phone (638) 844-2500

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000504 IL Practitioner - Optometry 9830151018 Receives reassigned benefits from 2 practitioners
Practice locations: North Aurora, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9 S Lincolnway
North Aurora, IL 60542-1608
Phone (630) 844-2500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046 007008ILMDOptometrist

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1912902115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 S LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421608",
            "telephone_number": "638-844-2500",
            "fax_number": "630-844-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 S LINCOLNWAY",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421608",
            "telephone_number": "638-844-2500",
            "fax_number": "630-844-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BILL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046 007008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Aurora, IL

Sources for this page

Verify at the official NPI Registry.