Medical school: NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated: 2006
NPI: 1003067661
Practice Locations (2)
K M B S C
422 W WHITE ST
CLINTON, IL 617272272
2179359571
K M B S C
1304 FRANKLIN AVE
NORMAL, IL 617613558
3092685128
Source: CMS National Downloadable File, September 2026.