Organization
DEACONESS ILLINOIS CLINIC, INC
Active
Other names
Deaconess Illinois Clinic 3411 Professional Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE DILLMAN (SECRETARY)
(812) 450-7399
Entity
Organization
Contact information
Practice address
3411 PROFESSIONAL PARK DR, MARION, IL 62959-6394
(618) 969-8630
(618) 969-8639
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
—
—
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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