SAMUEL PARK (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1720050495

SAMUEL PARK (MD) is a healthcare provider. based in Loves park, Illinois. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold the professional credentials MD. They hold a License No. 036063669 (IL). The NPI Number for SAMUEL PARK (MD) is 1720050495

Main info

Male
Name
SAMUEL PARK (MD)
NPI
1720050495
Phone
(815) 654-7772
Address
PO BOX 15785
Enumeration Date
6 February 2006
Last Update Date
18 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for SAMUEL PARK (MD)

  • PO BOX 15785

    LOVES PARK, IL 611325785

    Phone: (815) 654-7772

    Fax: (815) 654-7009

    Type: Mailing

  • Charles Street, Rockford, Winnebago County, Illinois, 61108, United States

    ROCKFORD, IL 611042224

    Phone: (815) 489-4267

    Fax: (815) 966-3967

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-09-08 • Largest payer in this snapshot: Amgen Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Amgen Inc.$15
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61132)

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Reviews

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Frequently asked questions

Can I use this page to confirm SAMUEL PARK (MD)'s NPI?
Yes. SAMUEL PARK (MD) is listed with NPI 1720050495 in the public NPI dataset.
Is SAMUEL PARK (MD) still practicing?
SAMUEL PARK (MD) is currently listed as active in the public NPI registry.
What is SAMUEL PARK (MD)'s primary classification?
Anatomic Pathology & Clinical Pathology Physician is the headline specialty for SAMUEL PARK (MD) here. Clinical services aligned with this taxonomy classification.
What area does SAMUEL PARK (MD) serve?
SAMUEL PARK (MD)'s listing highlights Loves Park, Illinois; more addresses can appear in NPPES.
Is the information about SAMUEL PARK (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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