OrganizationActive
Deaconess Illinois Specialty Clinic, Inc.
NPI 1679270763 · Occupational Health Nurse Practitioner · Mount Vernon, IL
Provider details
- NPI number
- 1679270763
- Entity type
- Organization
- Primary specialty
- Occupational Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kyle Dillman, Secretary(812) 450-7399
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3111 Broadway St
Mount Vernon, IL 62864-2338
Phone: (618) 241-0333
Fax: (618) 241-0334
Approximate (ZIP-level) locationGet directions
Mailing address
3111 Broadway St
Mount Vernon, IL 62864-2338
Other names (DBA / former)
- Doing business as
- Deaconess Illinois Specialty Clinic Occupational Health Broadway
Registry dates
- Enumerated
- 2023-02-09
- Last updated
- 2023-02-09
- Certified
- 2023-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.