| NPI | 1689381162 |
|---|---|
| Doing Business As | DEACONESS IL SPECIALTY 515 N MAIN 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 | 2022-11-03 |
| Last Update Date | 2023-01-26 |