| NPI | 1285350504 |
|---|---|
| Doing Business As | DEACONESS IL CLINIC 303 COMMERCIAL ST |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2023-07-28 |