Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1996
NPI: 1275534406
Practice Locations (1)
STATERA HEALTH CARE LLC
28 CHICK ST
METROPOLIS, IL 629602467
6184272680
Source: CMS National Downloadable File, September 2026.