Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1999
NPI: 1144333196
Practice Locations (1)
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1919 W TAYLOR ST
CHICAGO, IL 606127246
3129962901
Source: CMS National Downloadable File, September 2026.