Graduated: 2017
NPI: 1316290802
Practice Locations (2)
FUNCTIONAL PATHWAYS PREFERRED OF TENNESSEE LLC
2323 MCDANIEL AVE
EVANSTON, IL 602012549
8885312204
LEGACY HEALTHCARE SERVICES INC
335 RIDGE RD
WILMETTE, IL 600913282
2244082304
Source: CMS National Downloadable File, September 2026.