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Deaconess Illinois Clinic, Inc

Organization Active NPI Surgery Physician · Marion, IL

NPI 1407572860 · NPPES record last updated Dec 2, 2022

Key facts

NPI
1407572860
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
Legal business name
DEACONESS ILLINOIS CLINIC, INC
Practice address
3331 W Deyoung St
Marion, IL 62959-5896
Phone
(618) 998-7600
Fax
(618) 997-6680
NPI assigned
Oct 18, 2022
Organization subpart
No

Authorized official

Name
Kyle Dillman
Title
Secretary / Treasurer
Phone
(812) 450-7399

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Deaconess Illinois Clinic (21 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Cardiovascular Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RC0000X
Clinical Cardiac Electrophysiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RC0001X
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0100X
Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RH0003X
Interventional Cardiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RI0011X
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RP1001X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X Yes
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0129X
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208800000X
Colon & Rectal Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208C00000X
Podiatrist
Group: 193200000X MULTI-SPECIALTY GROUP		 213E00000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

3331 W Deyoung St
Marion, IL 62959-5896

Mailing address

PO Box 34156
Belfast, ME 04915-0619
Phone (812) 450-6815

Other names

  • Deaconess Illinois Clinic Doing business as

Other providers in Marion, IL

All providers in Marion, IL · Surgery Physician in Illinois

Sources for this page

Verify at the official NPI Registry.