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Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Other names
Deaconess Care Group Illinois Union County
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY)
(812) 450-7399
Entity
Organization
Contact information
Practice address
517 N MAIN ST, ANNA, IL 62906-1668
(618) 833-4511
Mailing address
PO BOX 632331, CINCINNATI, OH 45263-2331
(618) 833-4511
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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