Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY / TREASURER)
(812) 450-7399
Entity
Organization
Contact information
Practice address
1201 PINE ST, ELDORADO, IL 62930-1634
(812) 450-6815
(812) 450-6822
Mailing address
PO BOX 632331, CINCINNATI, OH 45263-2331
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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