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Organization
DEACONESS ILLINOIS CROSSROADS INC
Active
Organization
DEACONESS ILLINOIS CROSSROADS INC
Active
Other names
Southern Illinois Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
JARED STIMPSON (TREASURER)
(812) 450-8287
Entity
Organization
Contact information
Practice address
4119 S WATER TOWER PL STE A, MOUNT VERNON, IL 62864-6293
(618) 246-9595
Mailing address
4119 S WATER TOWER PL STE A, MOUNT VERNON, IL 62864-6293
(618) 246-9595
(618) 246-9592
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
01/11/2023
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