Graduated: 2020
NPI: 1851902704
Practice Locations (2)
ST MARYS HOSPITAL CENTRALIA ILLINOIS
400 N PLEASANT AVE
CENTRALIA, IL 628013056
6184368000
GOOD SAMARITAN REGIONAL HEALTH CENTER
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 628642402
5572031601
Source: CMS National Downloadable File, September 2026.