Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DERIC MINWOO PARK, MD
ActiveDERIC MINWOO PARK, MD is a Diagnostic Neuroimaging healthcare provider located in CHICAGO, Illinois. NPI 1730391509 is currently active in the NPPES registry. Verify at CMS.
Diagnostic Neuroimaging · CHICAGO, IL
Registration Details
- NPI Number
- 1730391509
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 4, 2007 (19.297667293758 yrs)
- Last Updated
- Sep 17, 2024
- Licenses
-
25MA11934400 (NJ)MD431575 (PA)0101247111 (VA)036147170 (IL)
Practice Information
- Address
-
5841 S MARYLAND AVE # MC2030CHICAGO, IL, 606371443Browse IL providers · Browse ZIP 60637
- Phone
- 7737021061
- Primary Specialty
-
Diagnostic Neuroimaging
2084D0003X
- Additional Specialty
- Diagnostic Neuroimaging
- Additional Specialty
- Neurology
- Additional Specialty
- Neurology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.