Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2001
NPI: 1255344289
Practice Locations (1)
ATHLETICO LTD
407 N LAGRANGE RD
LAGRANGE PARK, IL 605265623
7084829320
Source: CMS National Downloadable File, September 2026.