Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ji-Weon Park, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1952573511

Dr. Ji-Weon Park, MD is a Pathology in Lake Forest, Illinois. Qualified in 2005, 21 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Missouri.

Years since qualifying
21
Licensed in
IL, MO
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1000 N Westmoreland Rd # LL0519
Lake Forest, IL 60045-1658
Phone: (847) 535-6218
Fax: (847) 535-6237
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 216 S Kingshighway Blvd, Saint Louis, MO 63110-1026 — (314) 362-5641

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036137671 (IL)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence 2010009848 (MO)

Record details

NPI number1952573511
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2008
Last updated in NPPESMarch 24, 2023
Certification dateMarch 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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