NPIMap

Individual provider Active NPI

Yong J Park, RPH

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1922388404
Registry record updated Aug 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.289189 Issued in IL
Practice address
4801 N Lincoln Ave
Chicago, IL 60625-1915
Phone
(773) 561-2526
NPI assigned
Aug 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.289189 IL Primary

Addresses

Primary practice location

4801 N Lincoln Ave
Chicago, IL 60625-1915

Mailing address

4605 Birchwood Ave
Skokie, IL 60076-3872
Phone (847) 894-8726

Other names 1

  • Eric Park Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051.289189ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1314489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314489600000",
    "number": "1922388404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 BIRCHWOOD AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763872",
            "telephone_number": "847-894-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251915",
            "telephone_number": "773-561-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YONG",
        "middle_name": "J",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-28",
        "last_updated": "2011-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.289189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIC",
            "last_name": "PARK",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2011; 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.