DEACONESS IL SPECIALTY 513 N MAIN ST
NPI 1134836612
Orthopaedic Surgery in Anna, IL

NPI Status: Active since November 03, 2022

Contact Information

513 N MAIN ST
ANNA, IL
ZIP 62906
Phone: (618) 998-7177
Fax: (618) 998-7742

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  • Organization
  • Orthopaedic Surgery
  • CLIA Number: 14D2317473
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-23-2027

About DEACONESS IL SPECIALTY 513 N MAIN ST

This page provides the complete NPI Profile along with additional information for Deaconess Il Specialty 513 N Main St, a provider established in Anna, Illinois operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1134836612 assigned on November 2022. The practitioner's primary taxonomy code is 207X00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Deaconess Il Specialty 513 N Main St. The authorized official of this NPI record is Kyle Dillman (Secretary Treasurer)

NPI
1134836612
Provider Legal Name
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Other Organization Name
DEACONESS IL SPECIALTY 513 N MAIN ST
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
513 N MAIN ST ANNA, IL 62906
Location Phone
(618) 998-7177
Location Fax
(618) 998-7742
Mailing Address
PO BOX 34266 BELFAST, ME 04915
Mailing Phone
(812) 450-6815
Mailing Fax
(618) 998-7742
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-03-2022
Last Update Date
01-26-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KYLE DILLMAN

Authorized Official Title
SECRETARY TREASURER
Authorized Official Phone
(812) 450-7399

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2317473
Facility Type
Physician Office
Certificate Effective Date
January 24, 2025
Certificate Expiration Date
January 23, 2027
Laboratory Director
MARIE J. GORSKI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Deaconess Il Specialty 513 N Main St to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134836612, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
6
Unchanged
Pos 9
1
Doubled → 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 8 → 16 → 7 6 → 12 → 3 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 1 + 6 + 3 + 1 + 2 + 6 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1134836612.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
513 N MAIN ST
ANNA, IL 62906
Family Medicine
513 N MAIN ST
ANNA, IL 62906
Internal Medicine
513 N MAIN ST
ANNA, IL 62906
Obstetrics & Gynecology
513 N MAIN ST
ANNA, IL 62906
Dentist
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Family Medicine
513 N MAIN ST
ANNA, IL 62906
Clinic/Center (Federally Qualified Health Center (FQHC))
513 N MAIN ST
ANNA, IL 62906
Family Medicine
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Physician Assistant (Medical)
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Dentist (General Practice)
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Physician Assistant
513 N MAIN ST
ANNA, IL 62906
Dentist (General Practice)
513 N MAIN ST
ANNA, IL 62906
Case Manager/Care Coordinator
513 N MAIN ST
ANNA, IL 62906
Social Worker (Clinical)
513 N MAIN ST
ANNA, IL 62906
Social Worker (Clinical)
513 N MAIN ST
ANNA, IL 62906

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134836612, enumerated as an "organization" on November 03, 2022.

The provider is located at 513 N MAIN ST ANNA, IL 62906 and the phone number is (618) 998-7177.

Orthopaedic Surgery with taxonomy code 207X00000X.