Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1990
Also: PREVENTIVE MEDICINE
NPI: 1760449938
Practice Locations (2)
315 E MCKINLEY RD
OTTAWA, IL 613504805
8154340228
CLEANSLATE MEDICAL GROUP OF INDIANA LLC
101 N HARRISON ST
ALEXANDRIA, IN 460012017
4135842173
Source: CMS National Downloadable File, September 2026.