Graduated: 2022
Offers telehealth
NPI: 1730891466
Practice Locations (4)
119 S WESTERN AVE, UNIT 1
CHICAGO, IL 606124644
205 N SEMINOLE CIR
FORT WAYNE, IN 468072864
PO BOX
DALLAS, TX 75267
PO BOX, SUITE 679676
DALLAS, TX 752679676
Source: CMS National Downloadable File, September 2026.