Medical school: ALABAMA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2017
NPI: 1225560733
Practice Locations (2)
NORTHWESTERN MEDICAL FACULTY FOUNDATION
1 KISH HOSPITAL DR
DEKALB, IL 601159602
8157667334
STATERA HEALTH CARE LLC
200 E FAIRMAN AVE
WATSEKA, IL 609701644
8154325841
Source: CMS National Downloadable File, September 2026.