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DEACONESS IL SPECIALTY EXPRESS 2700 DEYOUNG
NPI 1134836695
Family Medicine in Marion, IL

Active since November 03, 2022CLIA 14D2146145 · Waiver
2700 W DEYOUNG ST STE F, MARION, IL 62959(618) 969-8633(618) 969-8639 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 26, 2023, Dec 2, 2022, Nov 9, 2022 and 1 more (4 updates tracked since 2022).

About Deaconess Il Specialty Express 2700 Deyoung NPPES

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

DEACONESS IL SPECIALTY EXPRESS 2700 DEYOUNG (NPI 1134836695) is a healthcare organization registered as a family medicine in Marion, Illinois and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through March 21, 2028 and lists Kyle Dillman, Secretary Treasurer, as its authorized official.

NPPES Registry Identity

NPI1134836695
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Location Address2700 W DEYOUNG ST STE FMarion, IL 62959-4943
Mailing AddressPo Box 34266Belfast, ME 04915-0620 · (812) 450-6815 · Fax (812) 450-6822
Phone(618) 969-8633
Fax(618) 969-8639
Organization SubpartNo
Authorized OfficialKyle DillmanSecretary Treasurer · (812) 450-7399
Enumeration DateNovember 3, 2022
Last NPPES UpdateJanuary 26, 20234 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2023
✔ NPI 1134836695 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
2700 W DEYOUNG ST STE F, Marion, IL 62959
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Other Names 1

Doing Business AsDeaconess Il Specialty Express 2700 Deyoung

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2146145

Deaconess Illinois Clinic Express · Marion, IL
Active · expires Mar 21, 2028
CLIA Number14D2146145
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorJodi Bryant
Laboratory Phone(618) 969-8633
Laboratory LocationDeaconess Illinois Clinic Express2700 W De Young St - Ste F, Marion, IL 62959
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MS. JOSHME RAWAL APRN
Nurse Practitioner
2700 W DEYOUNG ST STE F
MARION, IL 62959
Williamson County (618) 969-8633
KARA TIPSWORD FNP-C
Nurse Practitioner (Family)
2700 W DEYOUNG ST STE F
MARION, IL 62959
Williamson County (618) 969-8633
MRS. HEATHER DIANE ALEXANDER FNP-BC
Nurse Practitioner
2700 W DEYOUNG ST STE F
MARION, IL 62959
Williamson County (618) 998-7000

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 Specialty Clinic, Inc.'s NPI number?

The NPI number for Deaconess Illinois Specialty Clinic, Inc. is 1134836695. It was assigned to this organization in the NPPES registry on November 3, 2022. The provider is doing business as Deaconess Il Specialty Express 2700 Deyoung.

Where is Deaconess Illinois Specialty Clinic, Inc. located?

Deaconess Illinois Specialty Clinic, Inc. is located at 2700 W Deyoung St Ste F, Marion, IL 62959. The listed phone number is (618) 969-8633.

What is Deaconess Illinois Specialty Clinic, Inc.'s specialty?

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

Does Deaconess Illinois Specialty Clinic, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2146145) is associated with this NPI, valid through March 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deaconess Illinois Specialty Clinic, Inc. accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Deaconess Illinois Specialty Clinic, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deaconess Illinois Specialty Clinic, Inc. was last updated on January 26, 2023. 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.