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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.

NPI Number 1154036259
LBN Legal business name DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Authorized official KYLE DILLMAN - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 01/23/2023
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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