MINA PARK (NPI# 1023391604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023391604 |
| Entity Type | Individual |
| Full Name | MINA PARK |
| Credential | PHARMD |
| Practice Address |
1105 Brent Rd Northbrook IL 60062-5981 |
| Practice Telephone | 8475308360 |
| Mailing Telephone | 8475308360 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051292993 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417312406 | Mina Park | Registered Nurse | 8650 Belford Ave Apt 225, Los Angeles, CA 90045-4553 | 2015-12-18 |
| 1457919839 | Mina Grace Park | Student in an Organized Health Care Education/Training Program | 4800 Alberta Ave, El Paso, TX 79905-2709 | 2019-05-31 |
| Street Address |
1105 BRENT RD |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-5981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033677570 | Richele Aurea Amon Escobar | Pharmacist | 3276 Prestwick Ln, Northbrook, IL 60062-5123 | 2019-03-04 |
| 1700288305 | Lisa Young Kim | Pharmacist | 2100 Valencia Dr Apt 305, Northbrook, IL 60062-7088 | 2014-09-25 |
| 1063840270 | Susan E Wooden | Pharmacist | 2323 Capital Dr, Northbrook, IL 60062-6144 | 2013-10-24 |
| 1588940126 | Robert H Stensby | Pharmacist | 1050 Waukegan Road, Northbrook, ILLINOIS 60062 | 2011-10-27 |
| 1811279722 | John Hoon Chul Kim | Pharmacist | 101 Pointe Dr, Unit 102, Northbrook, IL 60062-1001 | 2011-09-16 |
| 1316146012 | Sheldon Orkin | Pharmacist | 3822 Rutgers Ln, Northbrook, IL 60062-3008 | 2007-07-12 |
| 1265657415 | Sanford William Foreman | Pharmacist | 1127 Church St, Northbrook, IL 60062-8302 | 2007-04-14 |
| 1316004385 | Michael Ma | Pharmacist | 707 Skokie Blvd, Suite 600, Northbrook, IL 60062-2857 | 2007-01-02 |
| 1194324566 | Alfunzo Kim | Pharmacist | 2323 Capital Dr, Northbrook, IL 60062-6144 | 2020-10-18 |
| 1568926426 | Stacey Jane Pan | Pharmacist | 2211 Sanders Rd, Northbrook, IL 60062-6150 | 2019-01-24 |
| Find all providers in NORTHBROOK | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on MINA PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.