Deaconess Illinois Specialty Clinic, Inc.

NPI #1629785183 in Benton, Illinois

Provider Information

NPI Number: 1629785183
Entity Type: Organization
Organization Name: Deaconess Illinois Specialty Clinic, Inc.
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Nov 3, 2022
Last Updated: Jan 26, 2023

Practice Location

Address: 205 BAILEY LN STE F
City: Benton
State: Illinois
ZIP Code: 62812-1921
Phone: (618) 882-4200

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Gastroenterology — Gastroenterology	207RG0100X
Surgery	208600000X
Nurse Practitioner	363L00000X
Orthopaedic Surgery	207X00000X	Primary

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