Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1990
NPI: 1083821037
Practice Locations (2)
FOUNDATION FOR OUTREACH SERVICES
326 W 64TH ST
CHICAGO, IL 606213114
7739623900
6307 S STEWART AVE, SUITE 307
CHICAGO, IL 606213116
7739664616
Source: CMS National Downloadable File, September 2026.