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DR. KENNETH WILLIAM PARK D.O.
NPI 1114928801
Family Medicine in Cary, IL

Active since August 03, 2005PECOS Enrolled
125 CARLISLE CT, CARY, IL 60013(847) 639-1685 Get Directions Write a Review

NPPES record last updated: August 13, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kenneth William Park D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH WILLIAM PARK D.O. (NPI 1114928801) is an individual family medicine provider in Cary, Illinois, licensed in Illinois (036055468) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114928801
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KENNETH WILLIAM PARKCredential: D.O.
Location Address125 CARLISLE CTCary, IL 60013-1908
Mailing Address125 Carlisle CtCary, IL 60013-1908 · (847) 639-1685
Phone(847) 639-1685
Sole ProprietorYes
Enumeration DateAugust 3, 2005
Last NPPES UpdateAugust 13, 2009
✔ NPI 1114928801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036055468
Definition
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.
125 CARLISLE CT, Cary, IL 60013
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Other Identifiers 2

Medicare ID-Type Unspecified208630IL · Medicare Part B Provider
Medicare UPINE34324IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth William Park D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Park's NPI number?

The NPI number for Kenneth Park is 1114928801. It was assigned to this individual provider in the NPPES registry on August 3, 2005.

Where is Kenneth Park located?

Kenneth Park practices at 125 Carlisle Ct, Cary, IL 60013. The listed phone number is (847) 639-1685.

What is Kenneth Park's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kenneth Park enrolled in Medicare?

Yes. Kenneth Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Park was last updated on August 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.