- Practice location
- 350 W South 1ST St, Red Bud, IL 62278-1116
- Phone
- 618-282-7373
- Fax
- 618-282-7376
- Last updated
- June 29, 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 1922715408. The current practice location address for Deaconess Illinois Specialty Clinic, INC. is 350 W South 1ST St, Red Bud, IL 62278-1116 and can be reached out via phone at 618-282-7373 and via fax at 618-282-7376.
Provider Profile Details
- NPI Number
- 1922715408
- Provider Name
- Deaconess Illinois Specialty Clinic, INC.
- Provider Entity Type
- Organization
- Address
- 350 W South 1ST St, Red Bud, IL 62278-1116
- Phone Number
- 618-282-7373
- Fax Number
- 618-282-7376
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Organization Subpart
- No
- Authorized Official
- Kyle Dillman · Secretary Treasurer · 812-450-7399
- Other Names
- Deaconess Il Specialty Spring St Multispecialty (Doing Business As)
St. Louis Cardiovascular (Doing Business As) - Provider Enumeration Date
- November 3, 2022
- Last Update Date
- June 29, 2023
- Certification Date
- June 29, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 350 W South 1ST St
Red Bud, IL 62278-1116 - City
- Red Bud
- State
- Illinois
- Zip
- 62278-1116
- Phone Number
- 618-282-7373
- Fax Number
- 618-282-7376
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)
- Internal Medicine, Interventional Cardiology · 207RI0011X
- Taxonomy (2)
- Surgery · 208600000X
- Taxonomy (3)
- Urology · 208800000X
- Taxonomy (5)
- Physician Assistant · 363A00000X
- Taxonomy (6)
- Nurse Practitioner · 363L00000X
- Taxonomy (7)
- 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 Red Bud, IL
View all Family 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 1922715408. 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 350 W South 1ST St, Red Bud, IL 62278-1116. The office can be reached at 618-282-7373 (phone) or 618-282-7376 (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 1922715408 directly on the NPPES registry website.