| Deaconess Illinois Specialty Clinic, Inc. | |
|
4117 S Water Tower Pl Ste C Mount Vernon IL 62864-6567 | |
| (618) 242-0672 | |
| (618) 242-0862 |
| Full Name | Deaconess Illinois Specialty Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4117 S Water Tower Pl Ste C, 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 Illinois Specialty Clinic, Inc. Po Box 34266 Belfast ME 04915-0620 Ph: (812) 450-6815 | Deaconess Illinois Specialty Clinic, Inc. 4117 S Water Tower Pl Ste C Mount Vernon IL 62864-6567 Ph: (618) 242-0672 |
| NPI Number | 1003523374 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 01/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003523374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
| 231H00000X | Audiologist | (* (Not Available)) | Secondary |
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 | |
Christopher Greater Area Rural Health Planning Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 S Water Tower Pl Ste D, Mount Vernon, IL 62864 Phone: 618-242-4848 | |
Deaconess Illinois Clinic, Inc 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, Inc 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 |