- Practice location
- 205 Bailey Ln Ste F, Benton, IL 62812-1921
- Phone
- 618-882-4200
- Fax
- 618-882-4208
- Last updated
- January 26, 2023
Deaconess Illinois Clinic, INC is a healthcare organization based in Benton, IL. Deaconess Illinois Clinic, INC practices in Benton, IL. The NPI Number for Deaconess Illinois Clinic, INC is 1790401081. The current practice location address for Deaconess Illinois Clinic, INC is 205 Bailey Ln Ste F, Benton, IL 62812-1921 and can be reached out via phone at 618-882-4200 and via fax at 618-882-4208.
Provider Profile Details
- NPI Number
- 1790401081
- Provider Name
- Deaconess Illinois Clinic, INC
- Provider Entity Type
- Organization
- Address
- 205 Bailey Ln Ste F, Benton, IL 62812-1921
- Phone Number
- 618-882-4200
- Fax Number
- 618-882-4208
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Organization Subpart
- No
- Authorized Official
- Kyle Dillman · Secretary · 812-450-7399
- Other Names
- Deaconess Il Clinic Bailey Ln (Doing Business As)
- Provider Enumeration Date
- October 18, 2022
- Last Update Date
- January 26, 2023
- Certification Date
- January 26, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 205 Bailey Ln Ste F
Benton, IL 62812-1921 - City
- Benton
- State
- Illinois
- Zip
- 62812-1921
- Phone Number
- 618-882-4200
- Fax Number
- 618-882-4208
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)
- Nurse Practitioner · 363L00000X
- Taxonomy (2)
- 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 Benton, IL
View all Family Medicine providers in Benton →Frequently Asked Questions
What is the NPI number of Deaconess Illinois Clinic, INC?
The NPI number of Deaconess Illinois Clinic, INC is 1790401081. It was assigned on October 18, 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 205 Bailey Ln Ste F, Benton, IL 62812-1921. The office can be reached at 618-882-4200 (phone) or 618-882-4208 (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 1790401081 directly on the NPPES registry website.