Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deaconess Illinois Specialty Clinic, Inc

Organization Interventional Cardiology Physician · NPI 1073220349

Deaconess Illinois Specialty Clinic, Inc is an Interventional Cardiology Physician in Sparta, Illinois. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

818 E Broadway St
Sparta, IL 62286-1820
Phone: (618) 939-4200
Fax: (618) 939-4256
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1073220349
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary Treasurer · (812) 450-7399
Other names Deaconess Il Specialty Broadway St; St. Louis Cardiovascular
NPI enumeratedNovember 4, 2022
Last updated in NPPESJanuary 26, 2023
Certification dateJanuary 26, 2023
Mailing addressPo Box 34266, Belfast, ME 04915-0620

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