Graduated: 2020
NPI: 1538877154
Practice Locations (3)
10208 S INDIANAPOLIS AVE, SUITE 301
Chicago, IL 606176033
10208 S INDIANAPOLIS AVE, SUITE 301
CHICAGO, IL 606176033
1101 CUMBERLAND XING, SUITE 108
VALPARAISO, IN 463832356
Source: CMS National Downloadable File, September 2026.