- Practice location
- 325 Spring St, Red Bud, IL 62278-1105
- Phone
- 618-282-3831
- Fax
- 618-282-3550
- Last updated
- January 26, 2023
Deaconess Illinois Specialty Clinic, INC. is a healthcare organization based in Red Bud, IL. Deaconess Illinois Specialty Clinic, INC. practices in Red Bud, IL. The NPI Number for Deaconess Illinois Specialty Clinic, INC. is 1053029330. The current practice location address for Deaconess Illinois Specialty Clinic, INC. is 325 Spring St, Red Bud, IL 62278-1105 and can be reached out via phone at 618-282-3831 and via fax at 618-282-3550.
Provider Profile Details
- NPI Number
- 1053029330
- Provider Name
- Deaconess Illinois Specialty Clinic, INC.
- Provider Entity Type
- Organization
- Address
- 325 Spring St, Red Bud, IL 62278-1105
- Phone Number
- 618-282-3831
- Fax Number
- 618-282-3550
- Primary Taxonomy
- Emergency Medicine · 207P00000X
- Organization Subpart
- No
- Authorized Official
- Kyle Dillman · Secretary Treasurer · 812-450-7399
- Other Names
- Deaconess Il Specialty Spring St Emergency (Doing Business As)
- Provider Enumeration Date
- November 7, 2022
- Last Update Date
- January 26, 2023
- Certification Date
- January 26, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 325 Spring St
Red Bud, IL 62278-1105 - City
- Red Bud
- State
- Illinois
- Zip
- 62278-1105
- Phone Number
- 618-282-3831
- Fax Number
- 618-282-3550
Provider Business Mailing Address Details
- Address
- Po Box 34266
Belfast, ME 04915-0620 - City
- Belfast
- State
- ME
- Zip
- 04915-0620
- Phone Number
- 812-450-6815
- Fax Number
- 812-450-6822
License Information
- Taxonomy (1)
- Family Medicine · 207Q00000X
- Taxonomy (2)
- Nurse Practitioner · 363L00000X
- Taxonomy (3)
- Emergency Medicine · 207P00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Emergency Medicine providers near Red Bud, IL
View all Emergency Medicine providers in Red Bud →Frequently Asked Questions
What is the NPI number of Deaconess Illinois Specialty Clinic, INC.?
The NPI number of Deaconess Illinois Specialty Clinic, INC. is 1053029330. It was assigned on November 7, 2022 and is currently active in the NPPES registry.
What is the specialty of Deaconess Illinois Specialty Clinic, INC.?
Deaconess Illinois Specialty Clinic, INC. is registered under the primary taxonomy Emergency Medicine (code 207P00000X).
Where does Deaconess Illinois Specialty Clinic, INC. practice?
The practice location is 325 Spring St, Red Bud, IL 62278-1105. The office can be reached at 618-282-3831 (phone) or 618-282-3550 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1053029330 directly on the NPPES registry website.