Medical school: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated: 1995
NPI: 1760592414
Practice Locations (2)
1770 E LAKE SHORE DR, SUITE 206
Decatur, IL 625213837
1770 E LAKE SHORE DR, SUITE 206
DECATUR, IL 625213837
2172331405
Source: CMS National Downloadable File, September 2026.