Deaconess Il Specialty 4113 Water Tower

LBN: Deaconess Illinois Specialty Clinic, Inc.
Deaconess Il Specialty 4113 Water Tower is an health care organization with primary practice located at 4113 S Water Tower Pl , Mount Vernon IL 62864-6293. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is the primary health care specialty. Deaconess Illinois Specialty Clinic, Inc. can be contacted via phone (618) 241-9071, or through Dillman, Kyle via phone (812) 450-7399.

Contact Information

Primary practice address
4113 S Water Tower Pl Mount Vernon IL 62864-6293
Phone: (618) 241-9071
Fax: (618) 241-9079
Website:
Map and Directions
Authorized official contact:
Name: Dillman, Kyle
Phone: (812) 450-7399

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1477260743
LBN Legal business name Deaconess Illinois Specialty Clinic, Inc.
DBA Doing business as Deaconess Il Specialty 4113 Water Tower
Authorized official Dillman, Kyle
Entity Organization
Organization subpart 1 No
Enumeration date Nov 4th, 2022
Last updated Jan 26th, 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.

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