Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1982
NPI: 1104809755
Practice Locations (1)
10801 S WESTERN AVE, SUITE 205
CHICAGO, IL 606433225
7082291600708229
Source: CMS National Downloadable File, September 2026.