Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1982
NPI: 1609870591
Practice Locations (1)
MACOUPIN FAMILY PRACTICE CENTERS LLP
715 BROADWAY ST
GILLESPIE, IL 620331166
2178394491
Source: CMS National Downloadable File, September 2026.