Graduated: 2009
NPI: 1972732725
Practice Locations (3)
55 E 86TH AVE, PO BOX 10645
MERRILLVILLE, IN 464100645
6121 CLEVELAND ST
MERRILLVILLE, IN 464102032
6121 CLEVELAND ST
MERRILLVILLE, IN 464102302
Source: CMS National Downloadable File, September 2026.