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PARK PRIMARY CARE LTD
NPI 1891984068
General Practice in Evergreen Park, IL

Active since October 23, 2007CLIA 14D1047764 · Waiver
9760 S KEDZIE AVE, SUITE 2, EVERGREEN PARK, IL 60805(708) 423-8150(708) 423-8152 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Park Primary Care Ltd NPPES

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

PARK PRIMARY CARE LTD (NPI 1891984068) is a healthcare organization registered as a general practice in Evergreen Park, Illinois and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through November 13, 2027 and lists George Thomas, Owner, as its authorized official.

NPPES Registry Identity

NPI1891984068
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePARK PRIMARY CARE LTD
Location Address9760 S KEDZIE AVE, SUITE 2Evergreen Park, IL 60805-3109
Mailing Address9760 S Kedzie Ave, Suite 2Evergreen Park, IL 60805-3109 · (708) 423-8150 · Fax (708) 423-8152
Phone(708) 423-8150
Fax(708) 423-8152
Organization SubpartNo
Authorized OfficialGeorge ThomasOwner · (708) 423-8150
Enumeration DateOctober 23, 2007
Last NPPES UpdateJune 17, 2025
NPPES CertifiedJune 17, 2025
✔ NPI 1891984068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
9760 S KEDZIE AVE, Evergreen Park, IL 60805
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Other Identifiers 1

OtherCA1215IL · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1047764

Park Primary Care, Ltd · Evergreen Park, IL
Active · expires Nov 13, 2027
CLIA Number14D1047764
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorThomas Joseph
Laboratory Phone(708) 423-8150
Laboratory LocationPark Primary Care, Ltd9760 S Kedzie, Ste 2, Evergreen Park, IL 60805
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

HEALTH SOLUTIONS AT HOME INC
Home Health
9760 S KEDZIE AVE, SUITE 10B
EVERGREEN PARK, IL 60805
Cook County (708) 346-9900
DR. GEORGE THOMAS M.D.
Family Medicine
9760 S KEDZIE AVE, SUITE 2
EVERGREEN PARK, IL 60805
Cook County (708) 423-8150
DR. FREDERICK EDWARD WOHLBERG M.D.
Urology
9760 S KEDZIE AVE, SUITE 6
EVERGREEN PARK, IL 60805
Cook County (708) 425-0112
DR. THOMAS JOSEPH M.D.
Internal Medicine
9760 S KEDZIE AVE, SUITE 2
EVERGREEN PARK, IL 60805
Cook County (708) 423-6209
ASHLEY ELIZABETH KNIGHT PA-C
Physician Assistant
9760 S KEDZIE AVE
EVERGREEN PARK, IL 60805
Cook County (708) 423-6209
DR. ANITA VACHA THAKADIYIL M.D
Family Medicine
9760 S KEDZIE AVE
EVERGREEN PARK, IL 60805
Cook County (708) 423-6209
EVERGREEN CARE CENTER LTD
General Practice
9760 S KEDZIE AVE, SUITE 3
EVERGREEN PARK, IL 60805
Cook County (708) 423-6209
MRS. RACHEL BRUCAS PA-C
Physician Assistant
9760 S KEDZIE AVE
EVERGREEN PARK, IL 60805
Cook County (708) 423-6209

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 Park Primary Care Ltd's NPI number?

The NPI number for Park Primary Care Ltd is 1891984068. It was assigned to this organization in the NPPES registry on October 23, 2007.

Where is Park Primary Care Ltd located?

Park Primary Care Ltd is located at 9760 S Kedzie Ave Suite 2, Evergreen Park, IL 60805. The listed phone number is (708) 423-8150.

What is Park Primary Care Ltd's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Park Primary Care Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1047764) is associated with this NPI, valid through November 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Park Primary Care Ltd was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.