Graduated: 1994
NPI: 1700922754
Practice Locations (2)
ROCKFORD HEALTH PHYSICIANS
8201 E RIVERSIDE BLVD
ROCKFORD, IL 611142300
8159712000
PRAIRIE RIDGE HEALTH INC
1515 PARK AVE
COLUMBUS, WI 539251618
9206232200
Source: CMS National Downloadable File, September 2026.