Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1987
Offers telehealth
NPI: 1417942822
Practice Locations (1)
PROVIDA HEALTH CENTER SC
1425 N HUNT CLUB RD, SUITE 100
GURNEE, IL 600312632
8475482200
Source: CMS National Downloadable File, September 2026.