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Contact Information

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
3329 W DEYOUNG ST
MARION, IL62959-5884
 Phone: 618-998-7177
 Fax: 618-998-7175
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

NPI Number 1386351856
LBN Legal business name DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Authorized official KYLE DILLMAN - (SECRETARY TREASURER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/03/2022
Last updated 01/26/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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