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

Olivia Park, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1669761748

Olivia Park, MD is a Physical Medicine and Rehabilitation in Kenosha, Wisconsin. Graduated from Medical College of Wisconsin in 2011, 15 years ago. Practices with Advantage Physical Therapy and Sports Rehab, LLC, a 286-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana and Wisconsin.

Years since qualifying
15
Trained at
Medical College of Wisconsin
Licensed in
IN, WI
In the registry since
2011
Specialties on file
3
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

6308 8th Ave
Kenosha, WI 53143-5031
Phone: (262) 771-0073
Show map & directions

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

Additional practice locations (2)

  • W180n8085 Town Hall Rd, Menomonee Falls, WI 53051-3518 — (262) 257-3550
  • 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 — (414) 805-7342

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 72450-20 (WI)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 01076676A (IN)
Spinal Cord Injury Medicine Physician Taxonomy 2081P0004X · Licence 72450-20 (WI)

Record details

NPI number1669761748
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 29, 2011
Last updated in NPPESDecember 3, 2025
Certification dateDecember 3, 2025
Mailing address1776 Woodstead Ct Ste 208, The Woodlands, TX 77380-1480

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2011 (15 years in practice)
Group practice Advantage Physical Therapy And Sports Rehab, Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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