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NPI Verification

National Provider Identifier: 1922715408

Deaconess Illinois Specialty Clinic, Inc.

Organization

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (7)

Internal Medicine, Interventional Cardiology

Code: 207RI0011X

Surgery

Code: 208600000X

Urology

Code: 208800000X

Code: 208VP0000X

Physician Assistant

Code: 363A00000X

Nurse Practitioner

Code: 363L00000X

Family Medicine

Code: 207Q00000X

Primary

Practice Address

350 W SOUTH 1ST ST

RED BUD, IL 622781116

Phone: 618-282-7373

NPI Enumeration Date

November 3, 2022

NPI Number

1922715408

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry