Graduated: 2019
NPI: 1275165342
Practice Locations (2)
IAS ILLINOIS PC
1969 W HART RD
BELOIT, WI 535112230
6083645011
DIVINE SAVIOR HEALTHCARE INC
2817 NEW PINERY RD
PORTAGE, WI 539019240
6087424131
Source: CMS National Downloadable File, September 2026.