Graduated: 2024
NPI: 1972351989
Practice Locations (2)
MD @ HOME ILLINOIS, SC
2003 W FULTON ST, SUITE 303
CHICAGO, IL 606122345
3122432223
PRIME HEALTHCARE ILLINOIS MEDICAL GROUP LLC
2233 W DIVISION ST
CHICAGO, IL 606228151
3127702000
Source: CMS National Downloadable File, September 2026.