Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Other names
Deaconess Illinois Specialty Clinic Occupational Health Broadway
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY)
(812) 450-7399
Entity
Organization
Contact information
Practice address
3111 BROADWAY ST, MOUNT VERNON, IL 62864-2338
(618) 241-0333
(618) 241-0334
Mailing address
3111 BROADWAY ST, MOUNT VERNON, IL 62864-2338
(618) 241-0333
(618) 241-0334
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up