Active NPIOrganization

Deaconess Illinois Clinic, INC

Family Medicine in Mount Vernon, Illinois

NPI Number1063128544
Practice location
4105 N Water Tower Pl, Mount Vernon, IL 62864-6296
Fax
—
Last updated
January 27, 2023

Deaconess Illinois Clinic, INC is a healthcare organization based in Mount Vernon, IL. Deaconess Illinois Clinic, INC practices in Mount Vernon, IL. The NPI Number for Deaconess Illinois Clinic, INC is 1063128544. The current practice location address for Deaconess Illinois Clinic, INC is 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 and can be reached out via phone at 812-450-6815.

Provider Profile Details

NPI Number
1063128544
Provider Name
Deaconess Illinois Clinic, INC
Provider Entity Type
Organization
Address
4105 N Water Tower Pl, Mount Vernon, IL 62864-6296
Phone Number
812-450-6815
Primary Taxonomy
Family Medicine · 207Q00000X
Organization Subpart
No
Authorized Official
Kyle Dillman · Secretary · 812-450-7399
Other Names
Deaconess Il Clinic 4105 N Water Tower (Doing Business As)
Provider Enumeration Date
January 27, 2023
Last Update Date
January 27, 2023
Certification Date
January 20, 2023
NPI Status
Active

Provider Business Practice Location Address Details

Address
4105 N Water Tower Pl
Mount Vernon, IL 62864-6296
Zip
62864-6296
Phone Number
812-450-6815
Mount Vernon, IL 62864Get directions →

Provider Business Mailing Address Details

Address
Po Box 34156
Belfast, ME 04915-0619
City
Belfast
State
ME
Zip
04915-0619
Phone Number
812-450-6815
Fax Number
812-450-6822

License Information

Taxonomy
Family Medicine · 207Q00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Deaconess Illinois Clinic, INC?

The NPI number of Deaconess Illinois Clinic, INC is 1063128544. It was assigned on January 27, 2023 and is currently active in the NPPES registry.

What is the specialty of Deaconess Illinois Clinic, INC?

Deaconess Illinois Clinic, INC is registered under the primary taxonomy Family Medicine (code 207Q00000X).

Where does Deaconess Illinois Clinic, INC practice?

The practice location is 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296. The office can be reached at 812-450-6815 (phone).

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 1063128544 directly on the NPPES registry website.

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