DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

MOUNT VERNON, IL
NPI1497462964
Doing Business AsDEACONESS IL SPECIALTY EXPRESS BROADWAY ST
Entity TypeOrganization
Authorized ContactKYLE DILLMAN
Secretary Treasurer
812-450-7399
Organization Subpart ?No
Primary Taxonomy363L00000X Nurse Practitioner
Additional Taxonomies207QS0010X Family Medicine, Sports Medicine
Enumeration Date2022-11-03
Last Update Date2023-01-26
Business Address
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
3111 BROADWAY ST
MOUNT VERNON, IL 62864-2338
Phone number: 618-241-0300
Mailing Address
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
PO BOX 34266
BELFAST, ME 04915-0620
Phone number: 812-450-6815
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