DEACONESS IL SPECIALTY BROADWAY ST
NPI 1073220349
Internal Medicine - Interventional Cardiology in Sparta, IL

Q: What is Deaconess Illinois Specialty Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Active since November 04, 2022

818 E BROADWAY ST, SPARTA, IL 62286(618) 939-4200(618) 939-4256 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 26, 2023, Dec 2, 2022, Nov 9, 2022 and 1 more (4 updates tracked since 2022).

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About Deaconess Il Specialty Broadway St NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEACONESS IL SPECIALTY BROADWAY ST (NPI 1073220349) is a healthcare organization registered as an interventional cardiology in Sparta, Illinois and active in the NPI registry since November 2022. The organization lists Kyle Dillman, Secretary Treasurer, as its authorized official.

NPPES Registry Identity

NPI1073220349

Entity TypeOrganization

Primary Taxonomy207RI0011X

Legal Business NameDEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Location Address818 E BROADWAY STSparta, IL 62286-1820

Mailing AddressPo Box 34266Belfast, ME 04915-0620 · (812) 450-6815 · Fax (812) 450-6822

Phone(618) 939-4200

Fax(618) 939-4256

Organization SubpartNo

Authorized OfficialKyle DillmanSecretary Treasurer · (812) 450-7399

Enumeration DateNovember 4, 2022

Last NPPES UpdateJanuary 26, 20234 updates tracked since enumeration

NPPES CertifiedJanuary 26, 2023

✔ NPI 1073220349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RI0011X

Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Also ListedPhysician AssistantTaxonomy 363A00000X

818 E BROADWAY ST, Sparta, IL 62286

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Other Names 2

Doing Business AsDeaconess Il Specialty Broadway St

Doing Business AsSt. Louis Cardiovascular

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA NELL STRICKLEY RD

Dietitian, Registered