Active NPI 1821165978 Individual Practitioner Male Practitioner

Dr. Marshall F Brustein , MD

Orthopaedic Surgery • Decatur, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Marshall Brustein, MD is a certified Orthopaedic Surgery practicing in Decatur, IL. With approximately 31 years of clinical experience since graduating from University Of Southern California Keck School Of Medicine in 1995, Dr. Brustein delivers high-quality medical care to the local community at 304 W HAY ST STE 112.

Dr. Brustein is affiliated with Springfield Clinic, Llp and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, established patient outpatient office visit, x-ray of shoulder, minimum of 2 views. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

304 W Hay St Ste 112

Decatur, IL 625266329

Telephone 2175287541

Associated Practice Facility / Clinic

🏢 Springfield Clinic, Llp Facility NPI 1780638478

Medicare Profile & Education

Medical School

University Of Southern California Keck School Of Medicine

Graduation Year

1995

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Decatur, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

31 Yrs -3.0 yrs vs City Avg

City Avg: 34.0 Yrs

State Avg: 27.0 Yrs

Regional Practice Density

5 Specialists

Practicing in Decatur, IL (1064 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

66.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Brustein (31 Years) 31 Yrs

Decatur Specialty Average (34.0 Years) 34.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1010 Injection, methylprednisolone acetate, 1 mg	9,750	142	$0.33	$0.13
99213 Established patient office or other outpatient visit, typically 15 minutes	418	251	$219.80	$80.60
73030 X-ray of shoulder, minimum of 2 views	305	165	$81.27	$29.75
73130 X-ray of hand, minimum of 3 views	214	137	$86.75	$32.01
20610 Aspiration and/or injection of fluid from large joint	205	118	$171.05	$63.12
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	147	113	$438.34	$162.22
73110 X-ray of wrist, minimum of 3 views	143	68	$94.76	$34.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	112	112	$408.15	$149.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	103	103	$271.17	$100.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	92	85	$310.62	$114.52
J1030 Injection, methylprednisolone acetate, 40 mg	68	54	$16.05	$6.35
26055 Incision of tendon covering	61	43	$724.63	$190.02
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	45	$135.85	$50.17
73140 X-ray of finger, minimum of 2 views	54	41	$88.65	$32.57
20550 Injection into tendon or ligament	41	29	$140.78	$48.49
20600 Aspiration and/or injection of fluid from small joint	38	27	$142.91	$49.36
73080 X-ray of elbow, minimum of 3 views	37	34	$76.95	$28.26
73070 X-ray of elbow, 2 views	35	16	$68.56	$25.14
64721 Release and/or relocation of hand nerve	32	28	$1086.66	$387.35
97607 Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session	27	26	$52.80	$19.29
23472 Prosthetic repair of shoulder joint, total shoulder	22	22	$3610.31	$1319.12
J1020 Injection, methylprednisolone acetate, 20 mg	19	13	$17.60	$6.94
23405 Incision of shoulder tendon	18	18	$1533.25	$280.11
20605 Aspiration and/or injection of medium joint or joint capsule	17	13	$137.59	$49.39
25600 Closed treatment of broken forearm bones	14	14	$847.99	$309.84
23600 Closed treatment of broken top of upper arm bone	12	12	$833.54	$291.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	375	236	$219.73	$86.34
73030 X-ray of shoulder, minimum of 2 views	343	159	$82.24	$32.43
J1030 Injection, methylprednisolone acetate, 40 mg	232	152	$19.20	$7.52
20610 Aspiration and/or injection of fluid from large joint	212	140	$173.56	$68.34
73110 X-ray of wrist, minimum of 3 views	187	66	$96.84	$38.17
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	174	136	$436.73	$169.18
73130 X-ray of hand, minimum of 3 views	169	116	$87.59	$34.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	100	90	$311.15	$122.84
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	99	99	$407.58	$160.94
J1020 Injection, methylprednisolone acetate, 20 mg	79	38	$14.41	$5.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	73	73	$274.27	$108.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	66	44	$136.80	$52.29
73140 X-ray of finger, minimum of 2 views	49	30	$89.68	$35.31
97607 Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session	38	34	$55.44	$21.83
20600 Aspiration and/or injection of fluid from small joint	31	21	$137.75	$49.62
20550 Injection into tendon or ligament	28	22	$142.40	$50.08
23472 Prosthetic repair of shoulder joint, total shoulder	28	28	$3633.66	$1420.65
73080 X-ray of elbow, minimum of 3 views	25	24	$77.60	$30.56
73070 X-ray of elbow, 2 views	25	11	$69.66	$27.49
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	24	24	$539.03	$213.17
64721 Release and/or relocation of hand nerve	23	21	$1085.02	$407.42
26055 Incision of tendon covering	22	17	$725.93	$244.31
20605 Aspiration and/or injection of medium joint or joint capsule	20	14	$139.09	$53.45
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	20	20	$430.60	$169.48
26720 Closed treatment of broken finger or thumb	16	13	$503.58	$179.69
25600 Closed treatment of broken forearm bones	14	14	$845.05	$332.82
23405 Incision of shoulder tendon	11	11	$1548.25	$332.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	430	262	$211.85	$87.52
73030 X-ray of shoulder, minimum of 2 views	340	156	$93.85	$32.82
J1100 Injection, dexamethasone sodium phosphate, 1 mg	215	36	$0.31	$0.12
20610 Aspiration and/or injection of fluid from large joint	208	126	$197.46	$67.61
73130 X-ray of hand, minimum of 3 views	204	138	$95.06	$34.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	165	127	$313.30	$123.39
73110 X-ray of wrist, minimum of 3 views	160	65	$103.01	$38.78
J1020 Injection, methylprednisolone acetate, 20 mg	158	80	$8.31	$3.23
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	118	118	$275.85	$109.46
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	116	85	$443.63	$170.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	110	110	$412.03	$158.44
J1030 Injection, methylprednisolone acetate, 40 mg	109	79	$19.03	$6.51
73140 X-ray of finger, minimum of 2 views	49	29	$90.98	$34.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	45	36	$137.95	$54.53
20600 Aspiration and/or injection of fluid from small joint	35	27	$133.34	$48.15
26055 Incision of tendon covering	33	26	$1007.94	$211.76
20550 Injection into tendon or ligament	33	25	$155.89	$48.95
64721 Release and/or relocation of hand nerve	30	26	$1124.32	$356.20
73080 X-ray of elbow, minimum of 3 views	30	25	$91.76	$31.00
73070 X-ray of elbow, 2 views	30	11	$72.84	$27.78
97607 Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session	28	28	$225.46	$22.57
23472 Prosthetic repair of shoulder joint, total shoulder	26	26	$4590.23	$1434.30
20605 Aspiration and/or injection of medium joint or joint capsule	23	19	$172.23	$50.63
25600 Closed treatment of broken forearm bones	19	19	$876.55	$332.28
J1040 Injection, methylprednisolone acetate, 80 mg	13	12	$27.08	$10.70
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	12	11	$67.02	$21.15
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$545.40	$199.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	843	443	$185.00	$89.86
J1030 Injection, methylprednisolone acetate, 40 mg	387	224	$20.00	$5.62
73030 X-ray of shoulder, minimum of 2 views	385	185	$143.00	$32.78
20610 Aspiration and/or injection of fluid from large joint	285	154	$301.00	$58.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	246	246	$276.00	$110.90
73130 X-ray of hand, minimum of 3 views	242	164	$124.00	$34.57
73110 X-ray of wrist, minimum of 3 views	225	87	$137.00	$38.44
73140 X-ray of finger, minimum of 2 views	65	34	$118.00	$35.71
20605 Aspiration and/or injection of medium joint or joint capsule	65	48	$230.00	$50.13
73070 X-ray of elbow, 2 views	43	20	$108.00	$28.06
26055 Incision of tendon covering	37	31	$2065.00	$228.58
20550 Injection into tendon or ligament	35	26	$250.00	$53.61
97607 Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session	34	33	$1000.00	$23.74
64721 Release and/or relocation of hand nerve	29	27	$2284.00	$412.48
73080 X-ray of elbow, minimum of 3 views	26	25	$136.00	$28.98
23472 Prosthetic repair of shoulder joint, total shoulder	23	23	$7723.00	$1485.09
25600 Closed treatment of broken forearm bones	22	22	$1082.00	$336.14
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$548.00	$199.74
25605 Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation	11	11	$2397.00	$520.36
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	11	11	$4165.00	$1069.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	862	435	$185.00	$73.35
J1030 Injection, methylprednisolone acetate, 40 mg	395	225	$20.00	$5.98
73030 X-ray of shoulder, minimum of 2 views	356	169	$143.00	$31.36
20610 Aspiration and/or injection of fluid from large joint	288	159	$301.00	$57.07
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	253	253	$276.00	$106.28
73130 X-ray of hand, minimum of 3 views	202	136	$124.00	$33.40
73110 X-ray of wrist, minimum of 3 views	173	69	$137.00	$36.15
73140 X-ray of finger, minimum of 2 views	67	39	$118.00	$33.89
20605 Aspiration and/or injection of medium joint or joint capsule	64	49	$230.00	$50.14
26055 Incision of tendon covering	45	30	$2065.00	$232.39
73070 X-ray of elbow, 2 views	42	16	$108.00	$27.32
20600 Aspiration and/or injection of fluid from small joint	36	25	$213.00	$47.31
64721 Release and/or relocation of hand nerve	34	30	$2284.00	$395.81
97607 Negative pressure wound therapy surface area less than or equal to 50 square centimeters per session	32	31	$1000.00	$23.77
23472 Prosthetic repair of shoulder joint, total shoulder	29	28	$7723.00	$1508.34
73080 X-ray of elbow, minimum of 3 views	20	20	$136.00	$29.72
29807 Repair of shoulder socket cartilage using an endoscope	16	16	$4211.00	$1037.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	14	14	$548.00	$205.30
25600 Closed treatment of broken forearm bones	14	14	$1082.00	$330.85
29075 Application of elbow to finger cast	13	13	$329.00	$55.29
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	12	12	$80.00	$20.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,024	510	$185.00	$71.18
J1030 Injection, methylprednisolone acetate, 40 mg	443	258	$20.00	$6.25
73030 X-ray of shoulder, minimum of 2 views	379	176	$143.00	$28.47
20610 Aspiration and/or injection of fluid from large joint	283	166	$301.00	$54.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	283	283	$276.00	$104.55
73130 X-ray of hand, minimum of 3 views	218	144	$124.00	$31.29
73110 X-ray of wrist, minimum of 3 views	205	82	$137.00	$34.31
73140 X-ray of finger, minimum of 2 views	144	82	$118.00	$31.57
20605 Aspiration and/or injection of medium joint or joint capsule	102	60	$230.00	$44.66
73070 X-ray of elbow, 2 views	86	34	$108.00	$25.45
20600 Aspiration and/or injection of fluid from small joint	61	45	$213.00	$44.61
26055 Incision of tendon covering	58	45	$2065.00	$243.46
64721 Release and/or relocation of hand nerve	43	38	$2284.00	$386.42
73080 X-ray of elbow, minimum of 3 views	39	36	$136.00	$28.10
23472 Prosthetic repair of shoulder joint, total shoulder	34	34	$7723.00	$1454.37
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$548.00	$199.82
29807 Repair of shoulder socket cartilage using an endoscope	17	17	$4211.00	$997.41
25600 Closed treatment of broken forearm bones	17	17	$1082.00	$310.67
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	15	15	$80.00	$19.74
29075 Application of elbow to finger cast	15	15	$329.00	$55.93
26600 Closed treatment of fracture hand bone	14	13	$1053.00	$272.92
20600 Aspiration and/or injection of fluid from small joint	14	12	$213.00	$18.15
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	13	13	$4485.38	$1043.75
20605 Aspiration and/or injection of medium joint or joint capsule	12	12	$230.00	$20.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$276.00	$75.62
64718 Release and/or relocation of elbow nerve	11	11	$2907.00	$511.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	958	482	$185.00	$65.98
J1030 Injection, methylprednisolone acetate, 40 mg	434	244	$20.00	$6.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	297	297	$276.00	$97.16
20610 Aspiration and/or injection of fluid from large joint	293	163	$301.00	$51.89
73030 X-ray of shoulder, minimum of 2 views	292	160	$143.00	$26.02
73130 X-ray of hand, minimum of 3 views	225	137	$124.00	$27.81
73110 X-ray of wrist, minimum of 3 views	204	88	$137.00	$30.58
73140 X-ray of finger, minimum of 2 views	152	87	$118.00	$28.54
20605 Aspiration and/or injection of medium joint or joint capsule	94	57	$230.00	$41.15
73070 X-ray of elbow, 2 views	65	27	$108.00	$24.30
20600 Aspiration and/or injection of fluid from small joint	55	40	$213.00	$42.21
64721 Release and/or relocation of hand nerve	51	45	$2284.00	$384.40
26055 Incision of tendon covering	34	29	$2065.00	$236.83
73080 X-ray of elbow, minimum of 3 views	27	24	$136.00	$28.04
73060 X-ray of upper arm, minimum of 2 views	25	11	$116.00	$25.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	23	23	$548.00	$189.46
29075 Application of elbow to finger cast	17	16	$329.00	$54.09
23472 Prosthetic repair of shoulder joint, total shoulder	16	16	$7723.00	$1336.43
29807 Repair of shoulder socket cartilage using an endoscope	16	16	$4211.00	$965.64
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	15	14	$80.00	$18.25
25600 Closed treatment of broken forearm bones	14	13	$1082.00	$301.77
26600 Closed treatment of fracture hand bone	14	14	$1053.00	$270.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$276.00	$71.91
23412 Repair of chronic torn shoulder rotator cuff	12	12	$3479.00	$403.82
20600 Aspiration and/or injection of fluid from small joint	12	11	$213.00	$16.89
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	11	11	$4165.00	$934.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	944	469	$185.00	$65.18
J1030 Injection, methylprednisolone acetate, 40 mg	420	242	$20.00	$5.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	321	321	$276.00	$97.12
20610 Aspiration and/or injection of fluid from large joint	303	167	$301.00	$50.87
73030 X-ray of shoulder, minimum of 2 views	270	147	$143.00	$25.16
73110 X-ray of wrist, minimum of 3 views	228	88	$137.00	$30.72
73140 X-ray of finger, minimum of 2 views	177	107	$118.00	$26.51
73130 X-ray of hand, minimum of 3 views	139	85	$124.00	$26.89
20605 Aspiration and/or injection of medium joint or joint capsule	81	55	$230.00	$40.83
73070 X-ray of elbow, 2 views	65	27	$108.00	$23.56
26055 Incision of tendon covering	50	40	$2065.00	$209.90
64721 Release and/or relocation of hand nerve	49	43	$2284.00	$360.14
20600 Aspiration and/or injection of fluid from small joint	43	36	$213.00	$40.80
73080 X-ray of elbow, minimum of 3 views	39	36	$136.00	$27.34
25600 Closed treatment of broken forearm bones	18	18	$1082.00	$294.69
Q4010 Cast supplies, short arm cast, adult (11 years +), fiberglass	13	12	$80.00	$19.07
20605 Aspiration and/or injection of medium joint or joint capsule	13	13	$230.00	$17.55
29075 Application of elbow to finger cast	13	12	$329.00	$45.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$278.00	$91.40
24105 Removal of fluid-filled sac of elbow	12	11	$1326.00	$292.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$276.00	$71.12

Medical Specialties & State Licenses

CMS Verified: 2025-05-28

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IL 036104593

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Durable Medical Equipment & Medical Supplies

NUCC Taxonomy Code: 332B00000X

State License IL 036104593

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036104593 (IL)

Hospital & Practice Group Affiliations

Springfield Clinic, Llp

775 Engineering Ave, Springfield, IL 627035909

Phone: 2175224300

Springfield Clinic, Llp

250 W Kenwood Ave, Decatur, IL 625264371

Phone: 2175287541

Springfield Clinic, Llp

304 W Hay St, Decatur, IL 625266328

Phone: 2175287541

Springfield Clinic, Llp

2300 N Edward St, Decatur, IL 625264163

Phone: 2175287541

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Kaitlin Henry , MD

Family Medicine

NPI 1003136276

Doctor of Medicine (M.D.)

Sydney Lynch

Physician Assistant - Surgical

NPI 1003404864

Jeremy Elliott

Nurse Practitioner - Family

NPI 1003416546

Jessica Lee , APN

Nurse Practitioner - Family

NPI 1003461831

Advanced Practice Nurse

Julie Hart , PA-C

Physician Assistant

NPI 1003867342

Physician Assistant (Certified)

Barbara Wolfson , LCPC

Counselor

NPI 1003900739

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location May 28, 2025

Registered at 304 W HAY ST STE 112, DECATUR, IL 625266329 (Tel: 2175287541)

📍

Updated Business Mailing Address May 28, 2025

Registered at PO BOX 19248, SPRINGFIELD, IL 627949248 (Tel: 2175287541)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2025

Durable Medical Equipment & Medical Supplies (License #036104593 in IL)

✅

NPI Profile Active May 30, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location May 30, 2008

Registered at 304 W HAY ST, SUITE 112, DECATUR, IL 625266328 (Tel: 2178728204)

📍

Updated Business Mailing Address May 30, 2008

Registered at 304 W HAY ST, SUITE 112, DECATUR, IL 625266328 (Tel: 2178728204)

👤

Provider Name / Credentials Updated May 30, 2008

Recorded as MARSHALL BRUSTEIN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2008

Orthopaedic Surgery (License #036104593 in IL)

🟢

Initial NPI Registration & Enumeration November 30, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1821165978

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 30, 2006

Last Update: May 28, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 19248

Springfield, IL 627949248

Phone: 2175287541

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.