JEFFREY D PARKS (NPI# 1215044367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215044367 |
| Entity Type | Individual |
| Full Name | JEFFREY D PARKS |
| Credential | M.D. |
| Practice Address |
405 Rushing Drive Herrin IL 62948-3730 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6189933300 |
| Practice Fax Number | 6189981802 |
| Mailing Telephone | 6184575200 |
| Mailing Fax Number | 6185290586 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2019-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036062597 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTH ALLIANCE | 033308 | 01 | |
| IL | 143870 | 05 | |
| BLUE CROSS/BLUE SHIELD | 10019630 | 01 | |
| RAILROAD MEDICARE | 080077375 | 01 | |
| IL | BLUE CROSS | 10019630 | 01 |
| HEALTHLINK | 103788 | 01 | |
| IL | 036062597 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750400701 | Jeffrey Parks | Social Worker | 38 Pond St, Suite 101, Franklin, MA 02038-3807 | 2007-03-29 |
| 1689745937 | Jeffrey Parks | Anesthesiology | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2006-11-10 |
| 1023045069 | Jeffrey C Parks | Physical Therapist | 880 A1a N, Ste 18a, Ponte Vedra Beach, FL 32082-3220 | 2006-06-26 |
| 1043254485 | Jeffrey D. Parks | Psychiatry & Neurology | 4420 Lake Boone Trl, Raleigh, NC 27607-7505 | 2006-06-16 |
| 1992757959 | Jeffrey C Parks | Surgery | 6770 Mayfield Rd, Suite 320, Mayfield Hts, OH 44124-2299 | 2006-05-17 |
| 1336134360 | Jeffrey Dean Parks | Dermatology | 400 Lakebridge Plaza Dr, Ormond Beach, FL 32174-5157 | 2005-09-15 |
| Street Address |
405 RUSHING DRIVE |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396850616 | Logan Primary Care Service Corp. | Clinic/Center | 405 Rushing Drive, Herrin, IL 62948 | 2006-08-19 |
| 1790052959 | Lab One Inc | Clinical Medical Laboratory | 405 Rushing Drive, Herrin, IL 62948-3730 | 2011-11-16 |
| 1184731267 | Michael Aaron Workman | Family Medicine | 405 Rushing Drive, Herrin, IL 62948 | 2006-08-24 |
| 1043327141 | Mark L Smith | Family Medicine | 405 Rushing Drive, Herrin, IL 62948 | 2006-08-24 |
| 1821105974 | Logan Primary Care Service Corporation | Family Medicine | 405 Rushing Drive, Herrin, IL 62948 | 2006-08-24 |
| 1902913908 | Kevin D Oestmann | Family Medicine | 405 Rushing Drive, Herrin, IL 62948 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942560172 | Awais Butt | Family Medicine | 3022 S Park Ave, Herrin, IL 62948-3721 | 2012-05-22 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1174722441 | Marshall Hillery Short | Family Medicine | 1500 Miller Drive, Herrin, IL 62948-2553 | 2007-07-16 |
| 1821102849 | Mark J Korte | Family Medicine | 405 Rushing Dr, Herrin, IL 62948-3730 | 2006-08-18 |
| 1750796629 | Khalid Mostafa Sonbol | Family Medicine | 201 S 14th St, Herrin, IL 62948-3631 | 2014-06-30 |
| 1649611252 | Charli Walter Leroy Smith Jr. | Family Medicine | 405 Rushing Dr, Herrin, IL 62948-3730 | 2013-07-11 |
| 1588918395 | Raja Kumari Vaidadi | Family Medicine | 201 S 14th St, Herrin, IL 62948-3631 | 2012-10-31 |
| 1003163148 | Joe V Yohannan | Family Medicine | 201 S 14th St, Herrin, IL 62948-3631 | 2012-08-08 |
| 1639457807 | Richard Kyle Buchman | Family Medicine | 405 Rushing Dr, Herrin, IL 62948-3730 | 2011-07-22 |
| 1134449275 | William F Hays Md, Ltd | Family Medicine | 3305 Logan Dr, Herrin, IL 62948-3732 | 2010-06-10 |
| Find all providers in HERRIN | ||||
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| 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.