Deaconess Illinois Clinic, INC
Family Medicine in Mount Vernon, Illinois
1558088138- Practice location
- 3111 Broadway St, Mount Vernon, IL 62864-2338
- Phone
- 618-241-0300
- Fax
- 618-241-0302
- Last updated
- December 2, 2022
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 1558088138. The current practice location address for Deaconess Illinois Clinic, INC is 3111 Broadway St, Mount Vernon, IL 62864-2338 and can be reached out via phone at 618-241-0300 and via fax at 618-241-0302.
Provider Profile Details
- NPI Number
- 1558088138
- Provider Name
- Deaconess Illinois Clinic, INC
- Provider Entity Type
- Organization
- Address
- 3111 Broadway St, Mount Vernon, IL 62864-2338
- Phone Number
- 618-241-0300
- Fax Number
- 618-241-0302
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Organization Subpart
- No
- Authorized Official
- Kyle Dillman · Secretary / Treasurer · 812-450-7399
- Other Names
- Deaconess Illinois Clinic (Doing Business As)
- Provider Enumeration Date
- October 24, 2022
- Last Update Date
- December 2, 2022
- Certification Date
- December 2, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3111 Broadway St
Mount Vernon, IL 62864-2338 - City
- Mount Vernon
- State
- Illinois
- Zip
- 62864-2338
- Phone Number
- 618-241-0300
- Fax Number
- 618-241-0302
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 (1)
- Family Medicine, Sports Medicine · 207QS0010X
- Taxonomy (2)
- Nurse Practitioner · 363L00000X
- Taxonomy (3)
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine providers near Mount Vernon, IL
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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 1558088138. It was assigned on October 24, 2022 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 3111 Broadway St, Mount Vernon, IL 62864-2338. The office can be reached at 618-241-0300 (phone) or 618-241-0302 (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 1558088138 directly on the NPPES registry website.