DR. Kenneth William Park, D.O.

NPI #1114928801 in Cary, Illinois

Provider Information

NPI Number: 1114928801
Entity Type: Individual
Name: DR. Kenneth William Park, D.O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Aug 3, 2005
Last Updated: Aug 13, 2009

Practice Location

Address: 125 CARLISLE CT
City: Cary
State: Illinois
ZIP Code: 60013-1908
Phone: (847) 639-1685

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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