Park, Anna J

Park, Anna J is an individual health care provider with primary practice located at 2015 N Main St , Wheaton IL 60187-3152. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Park, Anna J can be contacted via phone (630) 668-8250.

Contact Information

Primary practice address
2015 N Main St Wheaton IL 60187-3152
Phone: (630) 668-8250
Fax: (630) 668-8916
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036-107883 Illinois

Profile Details

NPI number 1295724144
LBN Legal business name Park, Anna J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Mar 19th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295724144 NPPES
Illinois Other P00132918 RR MEDICARE
Illinois MEDICAID 036107883 RR MEDICARE

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