Graduated: 2008
NPI: 1669517504
Practice Locations (3)
COOK COUNTY
2424 S PULASKI RD
CHICAGO, IL 606233718
7735210750
COOK COUNTY
500 E 51ST ST
CHICAGO, IL 606152494
3125722000
COOK COUNTY
5501 W FULLERTON AVE
CHICAGO, IL 606391368
3128640200
Source: CMS National Downloadable File, September 2026.