Physicians who wish to refer a patient can complete the Physician Referral Form  and send it via fax at: 312-355-1987

or the physician can call and speak with one of our physicians, nurse practitioners, or nurses at 312-355-1493.

Nurse Practitioner/Nurse

  • Myriam Davis, MS, NP
  • Darice Linares, APRN
  • Urszula Wysocka-Piesiewicz, FNP-BC
  • Karen Dancy, RN, BS

Having this information in advance may allow us to expedite appointment time, diagnosis, and treatment recommendations:

  1. Patient demographics and insurance information
  2. Referring physician information
  3. Medical records including imaging study films/disk and medications

We will make every effort to see referred patients within one week. We will also try to communicate with referring physician and fax records of our recommendation.

Note: New patients will need to register into our system by calling 312-355-4300

For physician-to-physician communication and consultation or to efficiently and safely transfer patients to the University of Illinois Hospital, please contact the Illinois Provider Access Line (IPAL), 24 hours a day, 7 days a week at (855) 455-IPAL (4725)