Deric Park, MD
Deric Park, MD is a Diagnostic Neuroimaging (Psychiatry & Neurology) Physician in Chicago, IL, registered under NPI 1730391509. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 5841 S MARYLAND AVE # MC2030, Chicago, IL 60637. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 25MA11934400 | NJ | Diagnostic Neuroimaging (Psychiatry &… primary |
| MD431575 | PA | Diagnostic Neuroimaging (Psychiatry &… |
| 0101247111 | VA | Neurology Physician |
| 036147170 | IL | Neurology Physician |
Licences are recorded in 4 states: NJ, PA, VA, IL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Neurology
- PAC ID
- 8729186614
Enrolled in Medicare 2 times, across 2 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Illinois | I20181015000575 | Practitioner - Neurology |
| New Jersey | I20230830000956 | Practitioner - Neurology |
Medicare enrolment is recorded as approved under the provider type Practitioner - Neurology. There are 2 separate enrolment records across 2 states (IL, NJ). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 4 states
This provider holds licences in 4 states: Illinois, New Jersey, Pennsylvania and Virginia. The practice address on file is in Chicago, IL, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 036147170
- Specialty
- Neurology Physician
- Licence
- 25MA11934400
- Specialty
- Diagnostic Neuroimaging (Psychiatry &…
- Licence
- MD431575
- Specialty
- Diagnostic Neuroimaging (Psychiatry &…
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Diagnostic Neuroimaging covers
A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging. NUCC Health Care Provider Taxonomy, code 2084D0003X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician Diagnostic Neuroimaging | 25MA11934400 | NJ | primary |
| 2084D0003X | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician Diagnostic Neuroimaging | MD431575 | PA | |
| 2084N0400X | Neurology Physician Neurology | 0101247111 | VA | |
| 2084N0400X | Neurology Physician Neurology | 036147170 | IL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1730391509 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 4, 2007 |
| Last updated | Sep 17, 2024 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
5841 S MARYLAND AVE # MC2030 Chicago, IL 60637 (773) 702-1061 |
| Mailing address |
150 HARVESTER DR STE 300 Burr Ridge, IL 60527 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 3 | 0 | 3 | 9 | 1 | 5 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 6 | 0 | 6 | 9 | 2 | 5 | 0 |
Sum = 61 · next multiple of 10 = 70 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.