Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1998
Offers telehealth
NPI: 1134199698
Practice Locations (1)
ASCENSION MEDICAL GROUP PROMED
7901 ANGLING RD
PORTAGE, MI 490240714
Source: CMS National Downloadable File, September 2026.