| Doctor Name: | DR. KEUM ZA PARK |
| NPI Number: | 1407072960 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 750 S State St Elgin, IL - 601237612 |
| Business Phone Number: | 8477421040 |
| Business Fax Number: | |
| Mailing Address: | 55 Regent Dr, GILBERTS |
| State: | IL |
| Postal Code: | 601364056 |
| Phone Number: | 8476956258 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |