Medical school: UNIV OF ILLINOIS AT CHICAGO COLLEGE OF DENTISTRY
Graduated: 2003
NPI: 1720074206
Practice Locations (3)
500 W RIVER DR
DAVENPORT, IA 528011014
1300 W 2ND ST
ROCK FALLS, IL 610711005
9425 DELEGATES ROW
INDIANAPOLIS, IN 462403805
Source: CMS National Downloadable File, September 2026.