SUE M PARK APN NPI 1578700522

NPI Information

  • NPI: 1578700522
  • Provider Name: SUE M PARK, APN
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 225 E CHICAGO AVE # 19
    CHICAGO, IL
    ZIP 60611
  • Phone: (312) 227-5157

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NPI Details

Sue M Park, APN is a pediatrics nurse practitioner in Chicago, IL. Sue M Park, APN NPI is 1578700522. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

225 E CHICAGO AVE # 19
CHICAGO, IL
ZIP 60611-991
Phone: (312) 227-5157
Fax: (312) 227-9730

The enumeration date for this NPI number is 1/13/2009 and was last updated on 2/4/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics209.007061041.336475ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11801058086MEDICAIDILLINOIS
21578700522MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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