Individual provider Active NPI

Junseok Park, D.C

  • Chiropractor
  • Schaumburg, IL
National Provider Identifier
1982069639
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012906 Issued in IL
Practice address
32 E Golf Rd
Schaumburg, IL 60173-3725
Phone
(847) 252-7474
Fax
(847) 252-7476
NPI assigned
Dec 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012906 IL Primary

Addresses

Primary practice location

32 E Golf Rd
Schaumburg, IL 60173-3725

Mailing address

32 E Golf Rd
Ez Pain & Rehab
Schaumburg, IL 60173-3725
Phone (847) 252-7474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218002623 IL Practitioner - Chiropractic 1658663042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 E Golf Rd
Schaumburg, IL 60173-3725
Phone (847) 252-7474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012906ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ez Spine and Joint Rehab Inc. Chiropractor CurrentSince Oct 6, 2023 Accepting new patients
JP Pain & Rehab Inc Chiropractor CurrentSince Nov 14, 2024 Accepting new patients

Locations

3524 Milwaukee Ave
Northbrook, IL 60062
Phone (630) 280-4576

32 E Golf Rd
Schaumburg, IL 60173
Phone (847) 252-7474

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1982069639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E GOLF RD",
            "address_2": "EZ PAIN & REHAB",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601733725",
            "telephone_number": "847-252-7474",
            "fax_number": "847-252-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E GOLF RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601733725",
            "telephone_number": "847-252-7474",
            "fax_number": "847-252-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNSEOK",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-23",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.