| Doctor Name: | CHUNG DAE PARK |
| NPI Number: | 1023377512 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 3648030 |
| Business Practice Address: | 17 Longmeadow Rd Winnetka, IL - 600933524 |
| Business Phone Number: | 8474461995 |
| Business Fax Number: | |
| Mailing Address: | 17 Longmeadow Rd, WINNETKA |
| State: | IL |
| Postal Code: | 600933524 |
| Phone Number: | 8474461995 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2012 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 3648030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |