MEDICARE: DR. JUNE COOK PARKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071-006866	IL

General Provider Information

NPI Number	:	1386877447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUNE COOK PARKS

Provider Business Mailing Address
First Line	:	5607 S DORCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1721
Country	:	US
Telephone Number	:	312-810-0111
Fax Number	:

Provider Business Practice Location Address
First Line	:	5607 S DORCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1721
Country	:	US
Telephone Number	:	312-810-0111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2009
Last Update Date	:	08/24/2009

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Directions to “ DR. JUNE COOK PARKS ” Practice Location

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