Medical school: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1984
NPI: 1841329489
Practice Locations (2)
HUMBOLDT PARK HEALTH
1044 N MOZART ST, SUITE 100
CHICAGO, IL 606223644
7732928200
2875 W 19TH ST
CHICAGO, IL 606233501
7734841000
Source: CMS National Downloadable File, September 2026.