| NPI | 1134836695 |
|---|---|
| Doing Business As | DEACONESS IL SPECIALTY EXPRESS 2700 DEYOUNG |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2023-01-26 |