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Organization
DEACONESS ILLINOIS CLINIC, INC
Active
Organization
DEACONESS ILLINOIS CLINIC, INC
Active
Other names
Deaconess Illinois Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY TREASURER)
(812) 450-7399
Entity
Organization
Contact information
Practice address
3331 W DEYOUNG ST, MARION, IL 62959-5896
(812) 450-6815
Mailing address
600 MARY ST, EVANSVILLE, IN 47710-1658
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2083X0100X
Occupational Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/02/2022
Last updated
01/19/2023
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