Provider Demographics
NPI:1639220445
Name:PARK, DENNIS J (DO)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:PARK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 TRANSAM PLAZA DR STE 410
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4290
Mailing Address - Country:US
Mailing Address - Phone:866-259-1631
Mailing Address - Fax:855-618-2629
Practice Address - Street 1:2 TRANSAM PLAZA DR STE 410
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4290
Practice Address - Country:US
Practice Address - Phone:866-259-1631
Practice Address - Fax:855-618-2629
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE602207R00000X
IL036.133095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine