Graduated: 1999
NPI: 1710265483
Practice Locations (3)
COOK COUNTY
1901 W HARRISON ST
CHICAGO, IL 606123714
3126337292
COOK COUNTY
500 E 51ST ST
CHICAGO, IL 606152494
3125722000
5872 N MILWAUKEE AVE
CHICAGO, IL 606465425
7732731447
Source: CMS National Downloadable File, September 2026.