NPI | 1063128544 |
---|---|
Doing Business As | DEACONESS IL CLINIC 4105 N WATER TOWER |
Entity Type | Organization |
Authorized Contact | KYLE DILLMAN Secretary 812-450-7399 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2023-01-27 |
Last Update Date | 2023-01-27 |