Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Other names
Deaconess IL Specialty Express 909 W Main St
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY)
(812) 450-7399
Entity
Organization
Contact information
Practice address
909 W MAIN ST STE 2, WEST FRANKFORT, IL 62896-2209
(812) 450-6815
(812) 450-6822
Mailing address
PO BOX 34266, BELFAST, ME 04915-0620
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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