Graduated: 2001
NPI: 1871706556
Practice Locations (2)
NEAR NORTH HEALTH SERVICE CORPORATION
1276 N CLYBOURN AVE
CHICAGO, IL 606102089
3123371073
NEAR NORTH HEALTH SERVICE CORPORATION
4259 S BERKELEY AVE
CHICAGO, IL 606533030
7732687600
Source: CMS National Downloadable File, September 2026.