| Deaconess Illinois Clinic, Inc | |
|
4105 N Water Tower Pl Mount Vernon IL 62864-6296 | |
| (812) 450-6815 | |
| Not Available |
| Full Name | Deaconess Illinois Clinic, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4105 N Water Tower Pl, Mount Vernon, 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 |
|---|---|
| Deaconess Illinois Clinic, Inc Po Box 34156 Belfast ME 04915-0619 Ph: (812) 450-6815 | Deaconess Illinois Clinic, Inc 4105 N Water Tower Pl Mount Vernon IL 62864-6296 Ph: (812) 450-6815 |
| NPI Number | 1063128544 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 01/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063128544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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