Dr Kelly Park, MD in Northbrook, IL

Dr Kelly Park, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Northbrook, Illinois. She went to Northeastern Ohio University College Of Medicine and graduated in 2009 and has 15 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Illinois Dermatology Institute Llc and her current practice location is 1200 Shermer Rd Ste 200, Northbrook, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 559-0090.

Dr Kelly Park is licensed to practice in Illinois (license number 036143099) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1659683993.

Contact Information

	Dr Kelly Park, MD
	1200 Shermer Rd Ste 200, Northbrook, IL 60062-4563
	(847) 559-0090
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Kelly Park
Gender	Female
Speciality	Dermatology
Experience	15 Years
Location	1200 Shermer Rd Ste 200, Northbrook, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Kelly Park attended and graduated from Northeastern Ohio University College Of Medicine in 2009

NPI Data:

NPI Number: 1659683993
Provider Enumeration Date: 07/01/2010
Last Update Date: 02/20/2024

Medicare PECOS Information:

PECOS PAC ID: 9830499417
Enrollment ID: I20170627001862

Medical Identifiers

Medical identifiers for Dr Kelly Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659683993	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	036.143099 (Illinois)	Secondary
207ND0101X	Dermatology - Mohs-micrographic Surgery	036143099 (Illinois)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Illinois Dermatology Institute Llc	7911043054	50

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kelly Park allows following entities to bill medicare on her behalf.

Entity Name	Illinois Dermatology Institute Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891920898 PECOS PAC ID: 7911043054 Enrollment ID: O20091005000156

Entity Name	Lakeside Dermatology
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508252875 PECOS PAC ID: 6800107459 Enrollment ID: O20150623001902

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kelly Park, MD 1800 Amberley Ct Apt 112, Lake Forest, IL 60045-1057 Ph: (330) 247-8419	Dr Kelly Park, MD 1200 Shermer Rd Ste 200, Northbrook, IL 60062-4563 Ph: (847) 559-0090

Reviews and Comments

Dermatology Doctors in Northbrook, IL

Peter S Hallarman, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 400 Skokie Blvd, Suite 475, Northbrook, IL 60062 Phone: 847-272-4433
Dr. Julie S Goldberg, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 513 Waukegan Rd, Northbrook, IL 60062 Phone: 847-205-0007 Fax: 847-205-0099
Gina C Marafino, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 400 Skokie Blvd, Suite 475, Northbrook, IL 60062 Phone: 847-272-4433
James G Lahti, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 400 Skokie Blvd, Suite 475, Northbrook, IL 60062 Phone: 847-272-4433
Renata M Jenkin, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 400 Skokie Blvd Ste 475, Northbrook, IL 60062 Phone: 847-272-4433 Fax: 847-272-4434
Anne K Bronner, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 400 Skokie Blvd, Suite 475, Northbrook, IL 60062 Phone: 847-272-4433

Dr Kelly Park, MD - Medicare Dermatology in Northbrook, IL