Deaconess Illinois Specialty Clinic, Inc.

NPI #1134836695 in Marion, Illinois

Provider Information

NPI Number: 1134836695
Entity Type: Organization
Organization Name: Deaconess Illinois Specialty Clinic, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Nov 3, 2022
Last Updated: Jan 26, 2023

Practice Location

Address: 2700 W DEYOUNG ST STE F
City: Marion
State: Illinois
ZIP Code: 62959-4943
Phone: (618) 969-8633

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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