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Contact Information

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
3331 W DEYOUNG ST STE 101
MARION, IL62959-5896
 Phone: 618-998-7169
 Fax: 618-998-7533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Occupational Health

364SX0106X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for DEACONESS ILLINOIS SPECIALTY CLINIC INC · (Female)

NPI Number 1154036259
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2023
Last updated 01/26/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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