Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Park, PA-C

Individual provider Physician Assistant · NPI 1528463346

Jacob Park, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2014, 12 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1740 W Taylor St Rm 724W
Chicago, IL 60612-7232
Phone: (402) 314-8567
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 85-005291 (IL)

Record details

NPI number1528463346
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 23, 2014
Last updated in NPPESFebruary 24, 2024
Certification dateFebruary 24, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Chicago