DR. PETER PARK (NPI# 1437762275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437762275 |
| Entity Type | Individual |
| Full Name | DR. PETER PARK |
| Credential | RPH |
| Practice Address |
1713 W Springfield Ave Champaign IL 61821-3011 |
| Mailing Address |
3402 Mission Dr Champaign IL 61822-9819 |
| Practice Telephone | 2173562529 |
| Mailing Telephone | 8474149769 |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2020-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051.302714 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033685177 | Peter Sungil Park | Obstetrics & Gynecology | 31874 Summer Grape Ct, Winchester, CA 92596-8633 | 2018-10-16 |
| 1699015792 | Peter Ju Park | Radiology | 100 Woodruff Cir Ne, Suite 327, Atlanta, GA 30322-0001 | 2013-02-26 |
| 1831296185 | Peter Joonsun Park | Emergency Medicine | 34800 Bob Wilson Dr. Naval Medical Center, Department of Emergency Medicine, San Diego, CA 92134-1110 | 2006-09-20 |
| 1508899915 | Peter C Park | Family Medicine | 30 Vt Route 100 S, Wilmington, VT 05363-7944 | 2006-07-09 |
| 1952359887 | Peter K Park | Physical Medicine & Rehabilitation | 6447 E Riverside Blvd, Suite 102, Rockford, IL 61114-4421 | 2006-05-04 |
| 1104825033 | Peter Sang-wook Park | Podiatrist | 1501 W Commonwealth Ave, Fullerton, CA 92833-2727 | 2005-07-21 |
| 1154937241 | Peter S Park | Student in an Organized Health Care Education/Training Program | 820 Memorial St Ste 1, Prosser, WA 99350-2504 | 2020-09-23 |
| 1831650043 | Peter K Park | Student in an Organized Health Care Education/Training Program | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2019-03-29 |
| 1508392176 | Peter Park | Social Worker | 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2017-05-02 |
| 1043672892 | Peter Yong Soo Park | Internal Medicine | 6431 Fannin St, Msb 2.116, Houston, TX 77030-1501 | 2016-03-22 |
| Street Address |
1713 W SPRINGFIELD AVE |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689689705 | Walgreen Co | Pharmacy | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2006-07-29 |
| 1649883406 | Azza Ali Abdelkarim | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2020-08-30 |
| 1275145351 | Niveda Baalasubramaniyan | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2020-08-19 |
| 1134525520 | Jian Xin Xie | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2014-11-12 |
| 1417351636 | Lauren Wagoner | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2014-10-17 |
| 1235531427 | Ciara Eileen Macenas | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2014-09-19 |
| 1346642881 | You Fen Lei | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2014-09-16 |
| 1235549064 | Jincy Philip | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2014-05-01 |
| 1205106374 | Roger Allan Marlow | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2012-01-06 |
| 1942579131 | Maxwell Wittler | Pharmacist | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2011-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801419809 | Ritika Chopra | Pharmacist | 2906 Stanley Ln, Champaign, IL 61822-1123 | 2020-05-26 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1154698827 | Nahid Rajaee Behbahani | Pharmacist | 4713 Stonebridge Dr, Champaign, IL 61822-3512 | 2011-11-24 |
| 1003191891 | Nazli Siddiqui | Pharmacist | 2506 Fields South Dr Apt 201, Champaign, IL 61822-3714 | 2011-10-12 |
| 1649592015 | Julie D. Bickers | Pharmacist | 3114 Village Office Pl, Champaign, IL 61822-7680 | 2010-02-25 |
| 1982938577 | Rajul Gandhi | Pharmacist | 2402 Village Green Place, Walgreens Pharmacy, Champaign, IL 61822-3512 | 2009-09-29 |
| 1518100866 | Michael F Smiricky | Pharmacist | 1211 Sussex Ct, Champaign, IL 61821-6918 | 2009-04-16 |
| 1063676112 | Bruce A Strike | Pharmacist | 1801 W Windsor Road, Champaign, IL 61822 | 2008-07-17 |
| 1326263013 | Dien Van-the | Pharmacist | 714 Krebs Dr, Champaign, IL 61822-1103 | 2007-04-16 |
| Find all providers in CHAMPAIGN | ||||
Please comment or provide details below to improve the information on DR. PETER PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.