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In a large skillet, heat 1 tablespoon of olive oil on medium-high heat. Add sliced onions and cook on high heat for about 10 minutes, stirring. Allow to lightly brown. Reduce heat and cook for 10 additional minutes. Add a pinch of salt. Continue cooking for an additional 10 minutes, stirring often.
Remove skillet from heat. To deglaze the pan, drizzle onions with a little balsamic vinegar, stir to coat and scrape the bottom of the pan. Plate onions and set aside.
Using the same skillet, heat 1 tablespoon of olive oil. Add sliced mushrooms and sprinkle with a pinch of salt. Cook mushrooms for about 5 minutes, stirring occasionally. With heat set to low, add fresh spinach to skillet, stir to combine and cook spinach just until it begins to wilt.
Add 1/2 cup of milk and 1/2 cup of heavy cream to mushroom and spinach mixture and bring to a boil. Reduce heat to simmer, add 2/3 cup shredded Parmesan cheese and ¼ teaspoon of salt, stirring continuously until cheese melts. Add the caramelized onions to the skillet and combine with the sauce.
Cook pasta according to package instructions. Add pasta to the creamy sauce and combine, stirring on low heat for a couple of minutes to reheat the sauce. If the sauce is too thick, add a little half and half; if too thin, add a little Parmesan cheese and simmer to reheat.
Serve with additional Parmesan cheese sprinkled on top.