Medical school: UNIV OF ILLINOIS AT CHICAGO COLLEGE OF DENTISTRY
Graduated: 1988
NPI: 1982609087
Practice Locations (2)
AFFILIATES IN ORAL AND MAXILLOFACIAL SURGERY LTD
3112 VILLAGE OFFICE PL
CHAMPAIGN, IL 618227680
2173517111
AFFILIATES IN ORAL AND MAXILLOFACIAL SURGERY LTD
3112 VILLAGE OFFICE PLACE
CHAMPAIGN, IL 618227680
Source: CMS National Downloadable File, September 2026.