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Organization

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Active
Other names
St. Louis Cardiovascular, Deaconess IL Specialty Kirkwood
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE DILLMAN (SECRETARY TREASURER)
(812) 450-7399
Entity
Organization

Contact information

Practice address
1028 S KIRKWOOD RD, SAINT LOUIS, MO 63122-7222
(314) 287-6184
(314) 394-2253
Mailing address
PO BOX 34266, BELFAST, ME 04915-0620
(812) 450-6815
(812) 450-6822

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
11/03/2022
Last updated
01/26/2023
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