NPI | 1982320289 |
---|---|
Doing Business As | DEACONESS ILLINOIS CLINIC |
Entity Type | Organization |
Authorized Contact | KYLE DILLMAN Secretary / Treasurer 812-450-7399 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Enumeration Date | 2022-10-18 |
Last Update Date | 2022-12-02 |