Deaconess Illinois Specialty Clinic, Inc.

NPI #1073220349 in Sparta, Illinois

Provider Information

NPI Number: 1073220349
Entity Type: Organization
Organization Name: Deaconess Illinois Specialty Clinic, Inc.
Primary Specialty: Internal Medicine - Interventional Cardiology
Enumeration Date: Nov 4, 2022
Last Updated: Jan 26, 2023

Practice Location

Address: 818 E BROADWAY ST
City: Sparta
State: Illinois
ZIP Code: 62286-1820
Phone: (618) 939-4200

Authorized Official

Name: KYLE DILLMAN
Title: SECRETARY TREASURER
Phone: (812) 450-7399

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X	Primary

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Organizations

Provider Name	Specialty	City
Deaconess Illinois Specialty Clinic, Inc.	Internal Medicine - Interventional Cardiology	Sparta	AI Deep Dive

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