| NPI | 1972210235 |
|---|---|
| Doing Business As | SOUTHERN ILLINOIS VEIN CLINIC |
| Doing Business As | RIVER TO RIVER HEART GROUP |
| Doing Business As | DEACONESS IL SPECIALTY 3331 DEYOUNG |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 174400000X Specialist |
| 207K00000X Allergy & Immunology | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| 208800000X Urology | |
| 208C00000X Colon & Rectal Surgery | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2023-08-07 |