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1194973768
KENNETH PARK
CHICAGO, IL
NPI
1194973768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085003022)
Enumeration Date
2008-09-08
Last Update Date
2022-08-31
Business Address
KENNETH PARK PA-C
3860 W OGDEN AVE
CHICAGO, IL 60623-2460
Phone number: 872-588-3000
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Mailing Address
KENNETH PARK PA-C
3860 W OGDEN AVE
CHICAGO, IL 60623-2460
Phone number: 872-588-3000
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