Deaconess Illinois Specialty Clinic, Inc
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
- 4
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
205 S Burns AveSparta, IL 62286-1867
Phone: (618) 443-2858
Fax: (618) 939-4256
Show map & directions
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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 |
| Medical Physician Assistant | Taxonomy 363AM0700X |
| Nurse Practitioner | Taxonomy 363L00000X |
Record details
| NPI number | 1619684172 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Kyle Dillman — Secretary Treasurer · (812) 450-7399 |
| Other names | Deaconess Il Specialty Burns Ave; St. Louis Cardiovascular |
| NPI enumerated | November 3, 2022 |
| Last updated in NPPES | January 26, 2023 |
| Certification date | January 26, 2023 |
| Mailing address | Po Box 34266, Belfast, ME 04915-0620 |
Other providers in Sparta
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Deaconess Illinois Specialty Clinic, Inc
818 E Broadway St, Sparta, IL 62286-1820 · (618) 939-4200