| 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 | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-12-02 |