Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1999
NPI: 1982706412
Practice Locations (1)
NORTHSHORE HEALTH CENTERS INC
6050 STERLING CREEK RD
PORTAGE, IN 463687752
21976381123233
Source: CMS National Downloadable File, September 2026.