Graduated: 2005
NPI: 1669789020
Practice Locations (4)
COOK COUNTY
1901 W HARRISON ST
CHICAGO, IL 606123714
3126337292
COOK COUNTY
500 E 51ST ST
CHICAGO, IL 606152494
3125722000
COOK COUNTY
5501 W FULLERTON AVE
CHICAGO, IL 606391368
3128640200
COOK COUNTY
1800 HARLEM AVE
NORTH RIVERSIDE, IL 605461468
7087839800
Source: CMS National Downloadable File, September 2026.