Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 1986
NPI: 1558302240
Practice Locations (2)
418 S POPLAR ST, SUITE 5
CENTRALIA, IL 628013940
6185332269
245 SAINT CLAIR SQ
FAIRVIEW HEIGHTS, IL 622082134
6186326550
Source: CMS National Downloadable File, September 2026.