Graduated: 1994
NPI: 1205846300
Practice Locations (3)
COOK COUNTY
1901 W HARRISON ST
CHICAGO, IL 606123714
3126337292
3303 S HALSTED ST, UNIT 203
CHICAGO, IL 606086877
3126744003
COOK COUNTY
500 E 51ST ST
CHICAGO, IL 606152494
3125722000
Source: CMS National Downloadable File, September 2026.