Graduated: 2023
NPI: 1851160873
Practice Locations (2)
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
3220 ATLANTA ST
SPRINGFIELD, IL 627078801
2175458000
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
520 N 4TH ST
SPRINGFIELD, IL 627025238
2175458000
Source: CMS National Downloadable File, September 2026.