Medical school: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1987
Offers telehealth
NPI: 1407948607
Practice Locations (2)
5005 N GLEN PARK PLACE RD
PEORIA, IL 616144677
3096861147
EDGEWOOD CLINICAL SERVICES P.C.
5901 N PROSPECT RD, SUITE 201A
PEORIA, IL 616144346
8884287890
Source: CMS National Downloadable File, September 2026.