| Deaconess Illinois Clinic, Inc | |
|
700 Logan College Drive J Building Carterville IL 62918 | |
| (618) 926-6698 | |
| Not Available |
| Full Name | Deaconess Illinois Clinic, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 700 Logan College Drive, Carterville, 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 Illinois Clinic, Inc Po Box 632330 Cincinnati OH 45263-2330 Ph: (618) 219-1311 | Deaconess Illinois Clinic, Inc 700 Logan College Drive J Building Carterville IL 62918 Ph: (618) 926-6698 |
| NPI Number | 1326836206 |
|---|---|
| Provider Enumeration Date | 04/29/2025 |
| Last Update Date | 05/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326836206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Si Vitality Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 W Commercial Dr Ste E, Carterville, IL 62918 Phone: 618-684-7087 Fax: 618-822-4045 | |
Si Vitality Specialty Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 W Commercial Dr Ste E, Carterville, IL 62918 Phone: 618-684-7087 Fax: 618-822-4045 |