| Deaconess Il Specialty Express Broadway St | |
|
3111 Broadway St Mount Vernon IL 62864-2338 | |
| (618) 241-0300 | |
| (618) 241-0302 |
| Full Name | Deaconess Il Specialty Express Broadway St |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 3111 Broadway St, Mount Vernon, Illinois |
| Authorized Official Name and Position | Kyle Dillman (SECRETARY TREASURER) |
| Authorized Official Contact | 8124507399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deaconess Il Specialty Express Broadway St Po Box 34266 Belfast ME 04915-0620 Ph: (812) 450-6815 | Deaconess Il Specialty Express Broadway St 3111 Broadway St Mount Vernon IL 62864-2338 Ph: (618) 241-0300 |
| NPI Number | 1497462964 |
|---|---|
| Provider Enumeration Date | 11/03/2022 |
| Last Update Date | 01/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497462964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Deaconess Il Specialty 4117 Water Tower Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 S Water Tower Pl Ste C, Mount Vernon, IL 62864 Phone: 618-242-0672 Fax: 618-242-0862 | |
Anderson Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3505 Broadway St, Mount Vernon, IL 62864 Phone: 618-244-7788 Fax: 618-244-9330 | |
Deaconess Illinois Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4105 N Water Tower Pl, Mount Vernon, IL 62864 Phone: 812-450-6815 | |
Deaconess Illinois Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 S Water Tower Pl, Mount Vernon, IL 62864 Phone: 618-242-0672 Fax: 618-242-0862 | |
Deaconess Illinois Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4113 S Water Tower Pl, Mount Vernon, IL 62864 Phone: 618-241-9071 Fax: 618-241-9079 | |
King City Physician Company, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864 Phone: 618-242-0672 Fax: 618-242-0862 | |
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