NPI 1558067488 · live from the CMS NPI Registry
Deaconess Illinois Specialty Clinic, INC.
Hospitalist in Marion, IL. National Provider Identifier 1558067488, active.
NPI record
| NPI | 1558067488 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospitalist 208M00000X |
| Practice location | 3333 W Deyoung St, Marion, IL 62959 |
| Practice phone | 618-998-7000 |
| Mailing address | Po Box 34266, Belfast, ME 04915 |
| Enumerated | February 2, 2023 |
| Last updated | January 19, 2025 |
| Authorized official | Kyle Dillman, Secretary |
| Other names | Deaconess Care Group Illinois |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology | 2084N0400X | — |
| Hospitalist primary | 208M00000X | — |
| Nurse Practitioner | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.