Deaconess Illinois Specialty Clinic, Inc.

NPI #1730896291 in Salem, Illinois

Provider Information

NPI Number: 1730896291
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: 1201 RICKER RD
City: Salem
State: Illinois
ZIP Code: 62881-4263
Phone: (182) 418-7916

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Orthopaedic Surgery	207X00000X	Primary

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