Graduated: 2013
NPI: 1629411129
Practice Locations (2)
IMPACT PHYSICIAN GROUP ILLINOIS LLC
3402 ANDERSON HEALTHCARE DR
EDWARDSVILLE, IL 620257712
6183077900
IMPACT PHYSICIAN GROUP MISSOURI LLC
12380 DEPAUL DR
BRIDGETON, MO 630442511
3144479700
Source: CMS National Downloadable File, September 2026.