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DEACONESS ILLINOIS CLINIC INC NPI 1407572860


NPI Information

NPI: 1407572860
Provider Name: DEACONESS ILLINOIS CLINIC, INC

Doing Business As: DEACONESS ILLINOIS CLINIC

Classification: Surgery - 208600000X
Entity Type: Organization
Address:
3331 W DEYOUNG ST
MARION, IL
ZIP 62959
Phone: (618) 998-7600
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DEACONESS ILLINOIS CLINIC, INC is a surgery in Marion, IL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. DEACONESS ILLINOIS CLINIC, INC NPI is 1407572860. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Illinois Clinic.

The provider's business location address is:

3331 W DEYOUNG ST
MARION, IL
ZIP 62959-896
Phone: (618) 998-7600
Fax: (618) 997-6680

The provider's authorized official is Kyle Dillman .
The authorized official title is Secretary / Treasurer and has the following contact phone number (812) 450-7399.

The enumeration date for this NPI number is 10/18/2022 and was last updated on 12/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyNo
4207RG0100XInternal MedicineGastroenterologyNo
5207RH0003XInternal MedicineHematology & OncologyNo
6207RI0011XInternal MedicineInterventional CardiologyNo
7207RP1001XInternal MedicinePulmonary DiseaseNo
82086S0129XSurgeryVascular SurgeryNo
9208800000XUrologyNo
10208C00000XColon & Rectal SurgeryNo
11213E00000XPodiatristNo
12363A00000XPhysician AssistantNo
13363L00000XNurse PractitionerNo
14208600000XSurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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