Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1995
NPI: 1194830661
Practice Locations (1)
MACOUPIN PHYSICIAN SERVICES, PC
20733 N BROAD ST
CARLINVILLE, IL 626263710
2178543141
Source: CMS National Downloadable File, September 2026.