| NPI | 1114644747 |
|---|---|
| Doing Business As | DEACONESS ILLINOIS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary / Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-12-02 |