Deaconess Il Clinic 17Th St

LBN: Deaconess Illinois Clinic, Inc
Deaconess Il Clinic 17Th St is an health care organization with primary practice located at 2703 17Th St Apt D , Marion IL 62959-4912. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Deaconess Illinois Clinic, Inc can be contacted via phone (618) 998-9200, or through Dillman, Kyle via phone (812) 450-7399.

Contact Information

Primary practice address
2703 17Th St Apt D Marion IL 62959-4912
Phone: (618) 998-9200
Fax: (618) 998-9700
Website:
Map and Directions
Authorized official contact:
Name: Dillman, Kyle
Phone: (812) 450-7399

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1326765090
LBN Legal business name Deaconess Illinois Clinic, Inc
DBA Doing business as Deaconess Il Clinic 17Th St
Authorized official Dillman, Kyle
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2022
Last updated Feb 2nd, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers