Graduated: 2019
NPI: 1073147161
Practice Locations (2)
ORTHOPAEDIC CENTER OF SOUTHERN ILLINOIS, LTD
4121 VETERANS MEMORIAL DR
MOUNT VERNON, IL 628646262
6182423778
PREMISE HEALTH OF ILLINOIS MEDICAL PC
5100 LAKE TER NE
MOUNT VERNON, IL 628649665
6188995001
Source: CMS National Downloadable File, September 2026.