Medical school: EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated: 1987
NPI: 1669486668
Practice Locations (2)
1750 E LAKE SHORE DR, SUITE 320
DECATUR, IL 625213806
2174220560
2965 N MAIN ST, SUITE A
DECATUR, IL 625264397
Source: CMS National Downloadable File, September 2026.