Provider Demographics
NPI:1710149968
Name:PARK LEONARD, CATHERINE K (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:K
Last Name:PARK LEONARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 COMMERCE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1546
Mailing Address - Country:US
Mailing Address - Phone:847-698-0600
Mailing Address - Fax:847-698-0601
Practice Address - Street 1:27750 W HIGHWAY 22
Practice Address - Street 2:SUITE G50
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2379
Practice Address - Country:US
Practice Address - Phone:847-842-0300
Practice Address - Fax:847-842-0370
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361314972085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL558620OtherMEDICARE PROVIDER NUMBER
IL778401OtherMEDICARE PROVIDER NUMBER
IL036131497Medicaid