SAMUEL PARK MD
NPI 1720050495
Pathology - Anatomic Pathology & Clinical Pathology in Rockford, IL
NPI Status: Active since February 06, 2006
Contact Information
1400 CHARLES ST
ROCKFORD, IL
ZIP 61104
Phone: (815) 489-4267
Fax: (815) 966-3967
- Individual
- Male
- Pathology
- Anatomic Pathology & Clinical Pathology
- Accepts Insurance
About SAMUEL PARK
This page provides the complete NPI Profile along with additional information for Samuel Park, a provider established in Rockford, Illinois with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1720050495 assigned on February 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number 036063669 (IL). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1720050495
- Provider Name
- SAMUEL PARK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1400 CHARLES ST ROCKFORD, IL 61104
- Location Phone
- (815) 489-4267
- Location Fax
- (815) 966-3967
- Mailing Address
- PO BOX 15785 LOVES PARK, IL 61132
- Mailing Phone
- (815) 654-7772
- Mailing Fax
- (815) 966-3967
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-06-2006
- Last Update Date
- 07-18-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pathology Anatomic Pathology & Clinical Pathology
- Taxonomy Code
- 207ZP0102X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036063669
- License State
- IL
- Taxonomy Description
- A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E34642 | MEDICARE UPIN (02) | ||
| 036063669 | MEDICAID (05) | IL | |
| L97825 | MEDICARE PIN (08) | IL |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 2 | 0 | 0 | 5 | 0 | 4 | 9 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 4 | 0 | 0 | 5 | 0 | 4 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 4 + 0 + 0 + 5 + 0 + 4 + 1 + 8 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1720050495 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1861464067 | REBEKHA NEU MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 1400 CHARLES ST ROCKFORD, IL 61104 (815) 489-4267 |
| 1457323628 | ROGER HILBERT MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 1400 CHARLES ST ROCKFORD, IL 61104 (815) 489-4267 |
| 1316919103 | HIULUI LAU MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 1400 CHARLES ST ROCKFORD, IL 61104 (815) 489-4267 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720050495, enumerated in the NPI registry as an "individual" on February 06, 2006
The provider is located at 1400 Charles St Rockford, Il 61104 and the phone number is (815) 489-4267
The provider's speciality is Pathology with taxonomy code 207ZP0102X with a focus in Anatomic Pathology & Clinical Pathology
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on February 06, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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