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

Samuel Park, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1720050495

Samuel Park, MD is an Anatomic Pathology & Clinical Pathology Physician in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
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

1400 Charles St
Rockford, IL 61104-2224
Phone: (815) 489-4267
Fax: (815) 966-3967
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036063669 (IL)

Record details

NPI number1720050495
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 6, 2006
Last updated in NPPESJuly 18, 2007
Mailing addressPo Box 15785, Loves Park, IL 61132-5785

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