DERIC MINWOO PARK

CHICAGO, IL
NPI1730391509
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: IL  036147170)
Additional Taxonomies2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging
(Licence: PA  MD431575)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: VA  0101247111)
Enumeration Date2007-05-04
Last Update Date2019-02-06
Business Address
DERIC MINWOO PARK MD
5841 S MARYLAND AVE # MC2030
CHICAGO, IL 60637-1443
Phone number: 773-702-1061
Mailing Address
DERIC MINWOO PARK MD
150 HARVESTER DR STE 300
BURR RIDGE, IL 60527-5965
Phone number: 773-702-1061