John Joohun Park, APRN is a medicare enrolled "Nurse Practitioner - Family" physician in Champaign, Illinois. His current practice location is
1907 W Springfield Ave Ste B, Champaign, Illinois. You can reach out to his office (for appointments etc.) via phone at
(217) 530-0220.
John Joohun Park is licensed to practice in Illinois (license number 209030497) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1477389773.
Physician's Profile
Full Name | John Joohun Park |
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Gender | Male |
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Speciality | Nurse Practitioner - Family |
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Location | 1907 W Springfield Ave Ste B, Champaign, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1477389773
- Provider Enumeration Date: 09/12/2024
- Last Update Date: 01/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 6608307772
- Enrollment ID: I20240930002714
Medical Identifiers
Medical identifiers for John Joohun Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477389773 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 209030497 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209030497 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. John Joohun Park allows following entities to bill medicare on his behalf.
Entity Name | Chambana Urgent Care And Walk In Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770358871 PECOS PAC ID: 5395196372 Enrollment ID: O20240104001617 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John Joohun Park is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
John Joohun Park, APRN 1907 W Springfield Ave Ste B, Champaign, IL 61821-3098 Ph: (217) 530-0220 | John Joohun Park, APRN 1907 W Springfield Ave Ste B, Champaign, IL 61821-3098 Ph: (217) 530-0220 |
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