Deaconess Illinois Specialty Clinic, Inc.

NPI #1922715408 in Red Bud, Illinois

Provider Information

NPI Number: 1922715408
Entity Type: Organization
Organization Name: Deaconess Illinois Specialty Clinic, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Nov 3, 2022
Last Updated: Jun 29, 2023

Practice Location

Address: 350 W SOUTH 1ST ST
City: Red Bud
State: Illinois
ZIP Code: 62278-1116
Phone: (618) 282-7373

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 Clinic, INC	Family Medicine	Red Bud	AI Deep Dive

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