Graduated: 1997
NPI: 1629175526
Practice Locations (2)
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
7435 W TALCOTT AVE
CHICAGO, IL 606313707
7737748000
MERCY HEALTH PHYSICIANS LIMA SPECIALTY CARE LLC
770 W HIGH ST, SUITE 160
LIMA, OH 458015900
4199965224
Source: CMS National Downloadable File, September 2026.