Organization
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Active
Other names
Deaconess IL Specialty Doctors Park
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE DILLMAN (SECRETARY / TREASURER)
(812) 450-7399
Entity
Organization
Contact information
Practice address
8 DOCTORS PARK RD, MOUNT VERNON, IL 62864-6224
(618) 244-1380
(618) 244-1380
Mailing address
PO BOX 632331, CINCINNATI, OH 45263-2331
(618) 244-1380
(618) 244-1380
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/30/2025
Last updated
01/31/2025
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