Deaconess Illinois Clinic, INC

NPI #1386361400 in Waterloo, Illinois

Provider Information

NPI Number
1386361400
Entity Type
Organization
Organization Name
Deaconess Illinois Clinic, INC
Primary Specialty
Family Medicine
Enumeration Date
Oct 20, 2022
Last Updated
Jan 26, 2023

Practice Location

Address
509 HAMACHER ST STE 102
ZIP Code
62298-1592
Phone
(812) 450-6815

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner
Internal Medicine - Geriatric MedicineGeriatric Medicine
Physician Assistant
Family Medicine

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