NPIMap

Individual provider Active NPI

Ji-Weon Park, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lake Forest, IL
National Provider Identifier
1952573511
Registry record updated Oct 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036137671 Issued in IL
Practice address
1000 N Westmoreland Rd # Ll0519
Lake Forest, IL 60045-1658
Phone
(847) 535-6218
Fax
(847) 535-6237
NPI assigned
Mar 24, 2008
Last updated
Oct 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036137671 IL Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2010009848 MO

Addresses

Primary practice location

1000 N Westmoreland Rd # Ll0519
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd # Ll0519
Lake Forest, IL 60045-1658
Phone (847) 535-6218

Other practice location 1

216 S Kingshighway Blvd
Saint Louis, MO 63110-1026
Phone (314) 362-5641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150824000203 IL Practitioner - Pathology 6204960867 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavilion E Lower Level Room 0519
Lake Forest, IL 60045-1658
Phone (847) 535-6218

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036137671ILMDAnatomic Pathology & Clinical Pathology Physician
2010009848MOMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pathologists P C Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients
University Pathology Diagnostics SC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2023 Accepting new patients
Pathology Associates of Aurora LLC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients
Parkway Pathology Group Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
Ste 570
Chicago, IL 60612

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

1000 N Westmoreland Rd
#519
Lake Forest, IL 60045
Phone (847) 535-6218

1000 N Westmoreland Rd
Lowr
Lake Forest, IL 60045
Phone (847) 535-6218

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792281600000",
    "number": "1952573511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LL0519",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-6218",
            "fax_number": "847-535-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LL0519",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-6218",
            "fax_number": "847-535-6237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 S Kingshighway Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101026",
            "country_code": "US",
            "telephone_number": "314-362-5641",
            "fax_number": "314-362-0369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JI-WEON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2026-10-18",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036137671",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2010009848",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.