ELISA PARK
NPI 1124623863
Pharmacist in Crystal Lake, IL

Active since December 01, 2020
1305 RANDALL RD, CRYSTAL LAKE, IL 60014(815) 356-0386 Get Directions Write a Review

NPPES record last updated: December 12, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 12, 2020, Dec 1, 2020 (2 updates tracked since 2020).

About Elisa Park NPPES

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

ELISA PARK (NPI 1124623863) is an individual pharmacist in Crystal Lake, Illinois, licensed in Illinois (051294615) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1124623863
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameELISA PARK
Location Address1305 RANDALL RDCrystal Lake, IL 60014-8601
Mailing Address1305 Randall RdCrystal Lake, IL 60014-8601
Sole ProprietorNo
Enumeration DateDecember 1, 2020
Last NPPES UpdateDecember 12, 20202 updates tracked since enumeration
NPPES CertifiedDecember 12, 2020
NPI 1124623863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in IL · 051294615
Definition

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.

1305 RANDALL RD, Crystal Lake, IL 60014

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Pharmacist
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Nurse Practitioner
1305 RANDALL RD
CRYSTAL LAKE, IL 60014
Nurse Practitioner (Family)
1305 RANDALL RD
CRYSTAL LAKE, IL 60014

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124623863, enumerated as an "individual" on December 01, 2020.

The provider is located at 1305 RANDALL RD CRYSTAL LAKE, IL 60014 and the phone number is (815) 356-0386.

Pharmacist with taxonomy code 183500000X.