IndividualActive
Deric Park, MD
NPI 1730391509 · Diagnostic Neuroimaging (Psychiatry & Neurology) Physician · Chicago, IL
Provider details
- NPI number
- 1730391509
- Entity type
- Individual
- Primary specialty
- Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 25MA11934400 (NJ)
Practice location
5841 S Maryland Ave # Mc2030
Chicago, IL 60637-1443
Phone: (773) 702-1061
Mailing address
150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965
Registry dates
- Enumerated
- 2007-05-04
- Last updated
- 2024-09-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.