Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1992
NPI: 1124125513
Practice Locations (4)
LEGACY PATH LLC
3355 DOUGLAS RD
SOUTH BEND, IN 466351779
5742344176
SOUTH BEND MEDICAL FOUNDATION INC
530 N LAFAYETTE BLVD
SOUTH BEND, IN 466011004
5742344176
SOUTH BEND MEDICAL FOUNDATION INC
1521 GULL RD
KALAMAZOO, MI 490481640
2692667231
LEGACY PATH LLC
1521 GULL RD
KALAMAZOO, MI 490481640
2692267231
Source: CMS National Downloadable File, September 2026.