NPI | 1770209082 |
---|---|
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 | 207RI0011X Internal Medicine, Interventional Cardiology |
208600000X Surgery | |
208800000X Urology | |
208VP0000X Pain Medicine, Pain Medicine | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2022-10-18 |
Last Update Date | 2022-12-02 |