| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SUE BIN PARK | 1427632140 | 2021-05-25 |
Sue Bin Park is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1427632140. Registration indicates Sue Bin Park is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Sue Bin Park DDS |
| Practice Office Address | 801 S PAULINA ST RM 304G CHICAGO, IL US |
| Practice Office Telephone | 3129967514 |
| Mailing Address | 1244 W MONROE ST UNIT 10 CHICAGO, IL 606072572 US |
| Business Telephone | 4259983380 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | 018.002172
IL |