Active NPIOrganization

Deaconess Illinois Specialty Clinic, INC.

Family Medicine in Mount Vernon, Illinois

NPI Number1841907409
Practice location
1 Good Samaritan Way, Mount Vernon, IL 62864-2402
Fax
—
Last updated
December 2, 2022

Deaconess Illinois Specialty Clinic, INC. is a healthcare organization based in Mount Vernon, IL. Deaconess Illinois Specialty Clinic, INC. practices in Mount Vernon, IL. The NPI Number for Deaconess Illinois Specialty Clinic, INC. is 1841907409. The current practice location address for Deaconess Illinois Specialty Clinic, INC. is 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 and can be reached out via phone at 618-242-4600.

Provider Profile Details

NPI Number
1841907409
Provider Name
Deaconess Illinois Specialty Clinic, INC.
Provider Entity Type
Organization
Address
1 Good Samaritan Way, Mount Vernon, IL 62864-2402
Phone Number
618-242-4600
Primary Taxonomy
Family Medicine · 207Q00000X
Organization Subpart
No
Authorized Official
Kyle Dillman · Secretary Treasurer · 812-450-7399
Other Names
Deaconess Il Specialty Good Samaritan (Doing Business As)
Provider Enumeration Date
November 3, 2022
Last Update Date
December 2, 2022
Certification Date
December 2, 2022
NPI Status
Active

Provider Business Practice Location Address Details

Address
1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Zip
62864-2402
Phone Number
618-242-4600
Mount Vernon, IL 62864Get directions →

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
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 Specialty Clinic, INC.?

The NPI number of Deaconess Illinois Specialty Clinic, INC. is 1841907409. It was assigned on November 3, 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 Family Medicine (code 207Q00000X).

Where does Deaconess Illinois Specialty Clinic, INC. practice?

The practice location is 1 Good Samaritan Way, Mount Vernon, IL 62864-2402. The office can be reached at 618-242-4600 (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 1841907409 directly on the NPPES registry website.

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