JACOB PARK (NPI# 1528463346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528463346 |
| Entity Type | Individual |
| Full Name | JACOB PARK |
| Credential | PA-C |
| Practice Address |
777 Park Ave W Highland Park IL 60035-2433 |
| Practice Telephone | 8479265844 |
| Mailing Telephone | 8479265844 |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 85-005291 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134342629 | Jacob Gyeongil Park | Dentist | 7434 Louis Pasteur Dr, Suite 303, San Antonio, TX 78229-4538 | 2007-04-11 |
| Street Address |
777 PARK AVE W |
| City | HIGHLAND PARK |
| State | IL |
| Zip Code | 60035-2433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609817220 | Northshore University Healthsystem | General Acute Care Hospital | 777 Park Ave W, Highland Park, IL 60035-2433 | 2006-06-08 |
| 1891325486 | Erin Kathryn Kieny | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2020-01-22 |
| 1982243036 | Jennifer Carolyn Peterson | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2020-01-06 |
| 1386288660 | Erika Tone | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2019-10-30 |
| 1811543937 | Lauren Rose Boivin | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2019-08-14 |
| 1255831426 | Andrea Fonacier | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2018-02-14 |
| 1518470657 | Jacqueline Yen Lam | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2017-11-12 |
| 1578088852 | Jessica Marie Zinnen | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2017-08-08 |
| 1699205724 | Claire Emery Hailey | Pediatrics | 777 Park Ave W, Highland Park, IL 60035-2433 | 2017-06-12 |
| 1164959342 | Karyn Michelle Gerstle | Pediatrics | 777 Park Ave W, Highland Park, IL 60035-2433 | 2017-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140006 | Julian Jay Freeman | Internal Medicine | 1954 1st St., Suite 263, Highland Park, IL 60035 | 2019-05-22 |
| 1851838858 | Melissa Block | Lactation Consultant, Non-RN | 303 Sheridan Road, Highland Park, IL 60035 | 2017-01-27 |
| 1750838280 | Megan Hyatt | Physical Therapist | Central Parkway, Store #210, Highland Park, IL 60035 | 2016-09-01 |
| 1962865907 | Timothy C Dennis | Counselor | 1724 1st St., Nicasa, Highland Park, IL 60035 | 2016-03-29 |
| 1821458027 | Sarah Marie Pinger | Counselor | 1724 1st Street, Highland Park, IL 60035 | 2016-03-01 |
| 1508262775 | Jennifer Francis Gilbert | Social Worker | 1067 Centerfield Court, Highland Park, IL 60035 | 2014-11-14 |
| 1588070148 | Hpoms | Clinic/Center | 1893 Sheridan Rd Suite 311, Highland Park, IL 60035 | 2014-07-03 |
| 1477974152 | Mtca Psychological Services of Illinois P.C. | Psychologist | 1651 Richfield Avenue, Highland Park, IL 60035 | 2013-12-23 |
| 1760819510 | Linda Beth Greco | Social Worker | 274 Linden Park Place, Highland Park, IL 60035 | 2013-10-10 |
| 1770821373 | Eve Cooper Agin | Counselor | 1866 Sheridan Road, Suite 203, Highland Park, IL 60035 | 2013-01-17 |
| Find all providers in zip 60035 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867396 | Laura Strohm | Physician Assistant | 777 Park Ave W # B-131a, Highland Park, IL 60035-2433 | 2018-07-17 |
| 1477672061 | Rebecca Kolko Friedlander | Physician Assistant | 777 Park Ave W Ste B131a, Highland Park, IL 60035-2497 | 2007-03-28 |
| 1821178518 | Amy Abdelnour Davisson | Physician Assistant | 15119 Woodward Ave, Highland Park, MI 48203-2907 | 2006-10-17 |
| 1811965973 | Sharon Denise Fellingham | Physician Assistant | 767 Park Ave West Suite #350, Park Ave. Associates In Internal Medicine, Highland Park, IL 60035 | 2006-03-14 |
| 1154931350 | Brittany Elizabeth Ells | Physician Assistant | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2020-08-03 |
| 1982236659 | Jenelle Dewald | Physician Assistant | 777 Park Ave W Ste B131a, Highland Park, IL 60035-2433 | 2020-02-10 |
| 1891325486 | Erin Kathryn Kieny | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2020-01-22 |
| 1982243036 | Jennifer Carolyn Peterson | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2020-01-06 |
| 1386288660 | Erika Tone | Physician Assistant | 777 Park Ave W, Highland Park, IL 60035-2433 | 2019-10-30 |
| 1942853304 | Cynthia Stamelos | Physician Assistant | 777 Park Ave W Ste B131a, Highland Park, IL 60035-2433 | 2019-07-24 |
| Find all providers in HIGHLAND PARK | ||||
| City | HIGHLAND PARK |
| Zip Code | 60035 |
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| 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.