Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1983
NPI: 1275579658
Practice Locations (1)
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
1401 E STATE ST
ROCKFORD, IL 611042315
3124133282
Source: CMS National Downloadable File, September 2026.