Deaconess Illinois Specialty Clinic, Inc.

Orthopedic Surgery · Benton, IL

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At a glance

205 Bailey Ln Ste F, Benton, IL 62812-1921

NPPES record updated Jan 26, 2023. Public records can lag behind changes at a practice.

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Practice location

205 Bailey Ln Ste F
Benton, IL 62812-1921

Professional details: NPI, taxonomy & registry record

NPI1629785183

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Registry details

Primary taxonomy: Orthopedic Surgery
Taxonomy code: 207X00000X
Enumeration date: Nov 3, 2022
Record updated: Jan 26, 2023

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

207RG0100X

Orthopedic Surgery

207X00000X · Primary

Surgery

208600000X

Nurse Practitioner

363L00000X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

205 Bailey Ln Ste F
Benton, IL 62812-1921

Phone: (618) 882-4200
Fax: (618) 882-4208

Mailing address

PO BOX 34266

BELFAST, ME 049150620

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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