Deaconess Illinois Clinic, INC

NPI #1770209082 in Red Bud, Illinois

Provider Information

NPI Number: 1770209082
Entity Type: Organization
Organization Name: Deaconess Illinois Clinic, INC
Primary Specialty: Family Medicine
Enumeration Date: Oct 18, 2022
Last Updated: Dec 2, 2022

Practice Location

Address: 325 SPRING ST
City: Red Bud
State: Illinois
ZIP Code: 62278-1105
Phone: (618) 939-2273

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X
Surgery	208600000X
Urology	208800000X
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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Organizations

Provider Name	Specialty	City
Red Bud Clinic Corp	Family Medicine	Red Bud	AI Deep Dive
Red Bud Illinois Hospital Company, LLC	Family Medicine	Red Bud	AI Deep Dive
Deaconess Illinois Specialty Clinic, Inc.	Family Medicine	Red Bud	AI Deep Dive

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