Organization · Type 2 NPI

Deaconess Illinois Specialty Clinic, Inc.

Interventional Cardiology Physician · St. Louis, MO

NPI number 1386351849 Active

Practice location

1028 S Kirkwood Rd
St. Louis, MO 63122-7222

Call (314) 287-6184 Map

Fax (314) 394-2253

Mailing address

PO Box 34266
Belfast, ME 04915-0620

Specialties and licenses

Taxonomy	Code	License
Interventional Cardiology Physician Primary	207RI0011X	None listed
Nurse Practitioner	363L00000X	None listed

Interventional Cardiology Physician: 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.

8 other providers at this address

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NPI record

NPI: 1386351849
Entity type: Organization (Type 2)
Issued: Nov 3, 2022
Last updated: Jan 26, 2023
Status: Active

Other names

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Deaconess Il Specialty Kirkwood · doing business as
St. Louis Cardiovascular · doing business as

Authorized official

Kyle Dillman
Secretary Treasurer
(812) 450-7399

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386351849

Deaconess Illinois Specialty Clinic, Inc.'s National Provider Identifier is 1386351849, issued on Nov 3, 2022. The primary taxonomy on file is Interventional Cardiology Physician (207RI0011X), and the practice location is in St. Louis, MO. The record was last updated on Jan 26, 2023.