Medical school: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated: 1994
Offers telehealth
NPI: 1093740490
Practice Locations (1)
PREMISE HEALTH OF ILLINOIS MEDICAL PC
6150 JOLIET RD
COUNTRYSIDE, IL 605253956
7084852273
Source: CMS National Downloadable File, September 2026.