Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 1997
NPI: 1255427779
Practice Locations (1)
NORTHWESTERN MEDICAL FACULTY FOUNDATION
1475 E BELVIDERE RD, PAVILION C SUITE 385
GRAYSLAKE, IL 600302026
3126941469
Source: CMS National Downloadable File, September 2026.