Medical school: AT STILL UNIVERSITY, ARIZONA SCHOOL OF DENTISTRY & ORAL HLTH
Graduated: 1997
NPI: 1497994354
Practice Locations (2)
1331 N MOHAWK ST, APT 1
CHICAGO, IL 606103568
5053 N MERRIMAC AVE
CHICAGO, IL 606301832
3125508707
Source: CMS National Downloadable File, September 2026.