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CHANG HWAN PARK MD
NPI 1487390308
Internal Medicine in Peoria, IL

Active since May 12, 2022PECOS EnrolledAccepts Medicare Assignment
221 NE GLEN OAK AVE STE W514, PEORIA, IL 61636(309) 672-5729(309) 672-5772 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Chang Hwan Park Md NPPES

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

CHANG HWAN PARK MD (NPI 1487390308) is an individual internal medicine provider in Peoria, Illinois, licensed in Illinois (036176023) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1487390308
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameCHANG HWAN PARKCredential: MD
Location Address221 NE GLEN OAK AVE STE W514Peoria, IL 61636-1000
Mailing Address221 Ne Glen Oak Ave Ste W514Peoria, IL 61636-1000 · (309) 672-5729
Phone(309) 672-5729
Fax(309) 672-5772
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 12, 2022
Last NPPES UpdateJune 24, 2026
NPPES CertifiedJune 24, 2026
✔ NPI 1487390308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036176023
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
221 NE GLEN OAK AVE STE W514, Peoria, IL 61636
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Chang Hwan Park Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911414958
PECOS Enrollment IDI20250725001288
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.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Proctor Hospital

Acute Care Hospitals · Peoria, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140013
Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County
Emergency services

Pekin Memorial Hospital

Acute Care Hospitals · Pekin, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140120
Location600 South 13th StreetPekin, IL 61554 · Tazewell County
Emergency services

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Carle Eureka Hospital

Critical Access Hospitals · Eureka, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141309
Location101 S Major StEureka, IL 61530 · Woodford County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61636 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
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.

Other Providers at the Same Location NPPES 3

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

DR. KASHIF S. HAQUE M.D.
Internal Medicine
221 NE GLEN OAK AVE STE W514
PEORIA, IL 61636
Peoria County (309) 672-5729
ASRA RAB M.D.
Internal Medicine
221 NE GLEN OAK AVE STE W514
PEORIA, IL 61636
Peoria County (309) 672-5522
SHAMS B ILAHI MD
Internal Medicine
221 NE GLEN OAK AVE STE W514
PEORIA, IL 61636
Peoria County (309) 671-5929

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 Chang Hwan Park's NPI number?

The NPI number for Chang Hwan Park is 1487390308. It was assigned to this individual provider in the NPPES registry on May 12, 2022.

Where is Chang Hwan Park located?

Chang Hwan Park practices at 221 NE Glen Oak Ave Ste W514, Peoria, IL 61636. The listed phone number is (309) 672-5729.

What is Chang Hwan Park's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Chang Hwan Park enrolled in Medicare?

Yes. Chang Hwan Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Chang Hwan Park affiliated with any hospitals?

According to CMS data, Chang Hwan Park is affiliated with Proctor Hospital, Pekin Memorial Hospital, Methodist Medical Center Of Illinois and Carle Eureka Hospital.

When was this NPI record last updated?

The NPPES record for Chang Hwan Park was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.