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Deactivated NPI 1023391604 Deactivated / Inactive NPI Female Practitioner

Dr. Mina Park , PharmD

Pharmacist • Northbrook, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mina Park has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 21, 2011
NPI Deactivation Date September 07, 2021
Total Practice Duration ~10 Years of Practice (2011 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Mina Park, PharmD was a registered Pharmacist practicing in Northbrook, IL. Throughout an active medical career spanning 10 years, Dr. Park provided care at the practice location at 1105 BRENT RD until profile deactivation on 2021-09-07.

Practice Location & Contact Primary Location

Practice Address

1105 Brent Rd

Northbrook, IL 600625981

Telephone 8475308360

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Northbrook, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
46 Specialists

Practicing in Northbrook, IL (9983 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License IL 051292993

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 07, 2021

Record deactivated on September 07, 2021

NPI Profile Active September 21, 2011

NPI status registered as active in NPPES database

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Updated Practice Location September 21, 2011

Registered at 1105 BRENT RD, NORTHBROOK, IL 600625981 (Tel: 8475308360)

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Updated Business Mailing Address September 21, 2011

Registered at 1105 BRENT RD, NORTHBROOK, IL 600625981 (Tel: 8475308360)

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Provider Name / Credentials Updated September 21, 2011

Recorded as MINA PARK, PHARMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2011

Pharmacist (License #051292993 in IL)

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Initial NPI Registration & Enumeration September 21, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023391604
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 21, 2011
Last Update: September 21, 2011
Deactivation Date: September 07, 2021

Mailing Address

1105 Brent Rd

Northbrook, IL 600625981

Phone: 8475308360

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.