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DEACONESS ILLINOIS CLINIC
NPI 1093432627
Family Medicine in Mount Vernon, IL

Active since October 25, 2022
4117 S WATER TOWER PL, MOUNT VERNON, IL 62864(618) 242-0672(618) 242-0862 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 2, 2022, Oct 25, 2022 (2 updates tracked since 2022).

About Deaconess Illinois Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEACONESS ILLINOIS CLINIC (NPI 1093432627) is a healthcare organization registered as a family medicine in Mount Vernon, Illinois and active in the NPI registry since October 2022. The organization lists Kyle Dillman, Secretary / Treasurer, as its authorized official.

NPPES Registry Identity

NPI1093432627
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEACONESS ILLINOIS CLINIC, INC
Location Address4117 S WATER TOWER PLMount Vernon, IL 62864-6567
Mailing AddressPo Box 34156Belfast, ME 04915-0619 · (812) 450-6815 · Fax (812) 450-6822
Phone(618) 242-0672
Fax(618) 242-0862
Organization SubpartNo
Authorized OfficialKyle DillmanSecretary / Treasurer · (812) 450-7399
Enumeration DateOctober 25, 2022
Last NPPES UpdateDecember 2, 20222 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
✔ NPI 1093432627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedAudiologistTaxonomy 231H00000X
4117 S WATER TOWER PL, Mount Vernon, IL 62864
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Other Names 1

Doing Business AsDeaconess Illinois Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES W NEAL M.D.
Family Medicine
4117 S WATER TOWER PL, SUITE D
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4848
NANCY K KERTZ NP
Nurse Practitioner (Family)
4117 S WATER TOWER PL, SUITE D
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4848
KING CITY PHYSICIAN COMPANY, LLC
Otolaryngology (Plastic Surgery within the Head & Neck)
4117 S WATER TOWER PL, SUITE C
MOUNT VERNON, IL 62864
Jefferson County (618) 242-0672
DAVID J LANE AU.D., CCC-A
Audiologist
4117 S WATER TOWER PL, SUITE C
MOUNT VERNON, IL 62864
Jefferson County (618) 242-0672
JACQUES PAPAZIAN M.D,S.C.
Otolaryngology
4117 S WATER TOWER PL, SUITE C
MOUNT VERNON, IL 62864
Jefferson County (618) 242-0672
MRS. MICHAELA PARCHMAN FNP-C
Nurse Practitioner (Family)
4117 S WATER TOWER PL
MOUNT VERNON, IL 62864
Jefferson County (618) 242-0672
DR. JACQUES PAPAZIAN M.D.
Family Medicine
4117 S WATER TOWER PL, SUITE C
MOUNT VERNON, IL 62864
Jefferson County (618) 242-0672
HEARTLAND OCCUPATIONAL MEDICINE PHYSICIANS OF ILLINOIS S C
Family Medicine
4117 S WATER TOWER PL, SUITE D
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4848

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deaconess Illinois Clinic, Inc's NPI number?

The NPI number for Deaconess Illinois Clinic, Inc is 1093432627. It was assigned to this organization in the NPPES registry on October 25, 2022. The provider is doing business as Deaconess Illinois Clinic.

Where is Deaconess Illinois Clinic, Inc located?

Deaconess Illinois Clinic, Inc is located at 4117 S Water Tower Pl, Mount Vernon, IL 62864. The listed phone number is (618) 242-0672.

What is Deaconess Illinois Clinic, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Deaconess Illinois Clinic, Inc was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.