Deaconess Illinois Specialty Clinic, Inc.

NPI #1619684172 in Sparta, Illinois

Provider Information

NPI Number: 1619684172
Entity Type: Organization
Organization Name: Deaconess Illinois Specialty Clinic, Inc.
Primary Specialty: Internal Medicine - Interventional Cardiology
Enumeration Date: Nov 3, 2022
Last Updated: Jan 26, 2023

Practice Location

Address: 205 S BURNS AVE
City: Sparta
State: Illinois
ZIP Code: 62286-1867
Phone: (618) 443-2858

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Physician Assistant - Medical — Medical	363AM0700X
Nurse Practitioner	363L00000X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X	Primary

Similar Providers

Individual Providers

Provider Name	Specialty	City
DR. Paul D. Ryan, M.D.	Internal Medicine - Interventional Cardiology	Hinsdale	AI Deep Dive
DR. Meechai Tessalee, M.D.	Internal Medicine - Interventional Cardiology	Hinsdale	AI Deep Dive
DR. Fadi Michel Shamsham, M.D.	Internal Medicine - Interventional Cardiology	Mt. Vernon	AI Deep Dive
DR. Yogesh K Agarwal, MD	Internal Medicine - Interventional Cardiology	Bloomington	AI Deep Dive

Organizations

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

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