| NPI | 1477260743 |
|---|---|
| Doing Business As | DEACONESS IL SPECIALTY 4113 WATER TOWER |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2023-01-26 |