| NPI | 1619684362 |
|---|---|
| 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 | 2083X0100X Preventive Medicine Occupational Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2023-01-19 |