Graduated: 2020
NPI: 1508476615
Practice Locations (2)
LOGAN PRIMARY CARE SERVICE CORP.
405 RUSHING DR
HERRIN, IL 629483730
SOUTHERN ILLINOIS MEDICAL SERVICES NFP
502 W SAINT LOUIS ST, SUITE 4
WEST FRANKFORT, IL 628961968
6189373400
Source: CMS National Downloadable File, September 2026.