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Organization
DEACONESS ILLINOIS CLINIC, INC
Active
Organization
DEACONESS ILLINOIS CLINIC, INC
Active
Other names
Deaconess IL Clinic 303 Commercial St
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY TREASURER)
(812) 450-7399
Entity
Organization
Contact information
Practice address
303 S COMMERCIAL ST, HARRISBURG, IL 62946-2125
(618) 918-6060
(618) 294-8238
Mailing address
PO BOX 34156, BELFAST, ME 04915-0619
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/18/2022
Last updated
07/28/2023
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