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3329 W Deyoung St Marion IL 62959-5884 | |
(618) 998-7177 | |
(618) 998-7175 |
Full Name | |
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Speciality | Family Medicine |
Location | 3329 W Deyoung St, Marion, Illinois |
Authorized Official Name and Position | Kyle Dillman (SECRETARY) |
Authorized Official Contact | 8124507399 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34156 Belfast ME 04915-0619 Ph: (812) 450-6815 | 3329 W Deyoung St Marion IL 62959-5884 Ph: (618) 998-7177 |
NPI Number | 1538886114 |
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Provider Enumeration Date | 10/24/2022 |
Last Update Date | 01/26/2023 |
Identifier | Type | State | Issuer |
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1538886114 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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