DR. EDWARD J PARK (M.D) – Physical Medicine & Rehabilitation Physician, NPI 1891787008

DR. EDWARD J PARK (M.D) is a healthcare provider. based in Westchester, Illinois. specializing in Physical Medicine & Rehabilitation Physician. They hold the professional credentials M.D. They hold a License No. 036-108857 (IL). The NPI Number for DR. EDWARD J PARK (M.D) is 1891787008

Main info

Male
Name
DR. EDWARD J PARK (M.D)
NPI
1891787008
Phone
(708) 786-2900
Address
1107 S MANNHEIM RD
Enumeration Date
16 August 2005
Last Update Date
21 December 2021

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for DR. EDWARD J PARK (M.D)

  • 1107, South Mannheim Road, Westchester, Proviso Township, Cook County, Illinois, 60154, United States

    WESTCHESTER, IL 601542561

    Phone: (708) 786-2900

    Type: Mailing

  • Schwab Rehabilitation Hospital, 1401, South California Avenue, North Lawndale, Chicago, Cook County, Illinois, 60608, United States

    CHICAGO, IL 606081858

    Phone: (773) 522-5120

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150925001594IPhysical Medicine And RehabilitationCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 60154)

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Reviews

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Frequently asked questions

Is DR. EDWARD J PARK (M.D) listed with a National Provider Identifier?
Yes — DR. EDWARD J PARK (M.D) has NPI 1891787008 on file in the registry.
Would DR. EDWARD J PARK (M.D) appear as active to a payer?
You can treat DR. EDWARD J PARK (M.D) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. EDWARD J PARK (M.D)?
DR. EDWARD J PARK (M.D)'s specialty line reads Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. EDWARD J PARK (M.D) registered?
Use Westchester, Illinois as the headline location for DR. EDWARD J PARK (M.D) here.
Can I trust this NPI listing for DR. EDWARD J PARK (M.D)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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