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DEACONESS ILLINOIS SPECIALTY CLINIC INC. NPI 1629785183


NPI Information

NPI: 1629785183
Provider Name: DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Doing Business As: DEACONESS IL SPECIALTY BAILEY LN

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
205 BAILEY LN STE F
BENTON, IL
ZIP 62812
Phone: (618) 882-4200
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DEACONESS ILLINOIS SPECIALTY CLINIC, INC. is an orthopaedic surgery in Benton, IL. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DEACONESS ILLINOIS SPECIALTY CLINIC, INC. NPI is 1629785183. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Il Specialty Bailey Ln.

The provider's business location address is:

205 BAILEY LN STE F
BENTON, IL
ZIP 62812-921
Phone: (618) 882-4200
Fax: (618) 882-4208

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 11/3/2022 and was last updated on 1/26/2023.


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
1207RG0100XInternal MedicineGastroenterologyNo
2208600000XSurgeryNo
3363L00000XNurse PractitionerNo
4207X00000XOrthopaedic SurgeryYes

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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