Park, Deric Minwoo
Park, Deric Minwoo is an individual health care provider with primary practice located at 5841 S Maryland Ave # Mc2030 , Chicago IL 60637-1443. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Park, Deric Minwoo can be contacted via phone (773) 702-1061.Contact Information
Primary practice address
5841 S Maryland Ave # Mc2030
Chicago IL 60637-1443
Phone: (773) 702-1061
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging | 2084D0003X | MD431575 | Pennsylvania |
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0101247111 | Virginia |
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036147170 | Illinois |
Profile Details
NPI number | 1730391509 |
---|---|
LBN Legal business name | Park, Deric Minwoo |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 4th, 2007 |
Last updated | Feb 6th, 2019 - about 6 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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