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DEACONESS ILLINOIS CLINIC
NPI 1225754526
Family Medicine in Sparta, IL

Active since October 18, 2022
205 S BURNS AVE, SPARTA, IL 62286(618) 443-2858(618) 939-4256 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2022, Oct 18, 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 1225754526) is a healthcare organization registered as a family medicine in Sparta, Illinois and active in the NPI registry since October 2022. The organization lists Kyle Dillman, Secretary / Treasurer, as its authorized official.

NPPES Registry Identity

NPI1225754526
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEACONESS ILLINOIS CLINIC, INC
Location Address205 S BURNS AVESparta, IL 62286-1867
Mailing AddressPo Box 34156Belfast, ME 04915-0619 · (812) 450-6815 · Fax (812) 450-6822
Phone(618) 443-2858
Fax(618) 939-4256
Organization SubpartNo
Authorized OfficialKyle DillmanSecretary / Treasurer · (812) 450-7399
Enumeration DateOctober 18, 2022
Last NPPES UpdateDecember 2, 20222 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
✔ NPI 1225754526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
205 S BURNS AVE, Sparta, IL 62286
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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

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

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Internal Medicine (Interventional Cardiology)
205 S BURNS AVE
SPARTA, IL 62286
Randolph County (618) 443-2858

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 1225754526. It was assigned to this organization in the NPPES registry on October 18, 2022. The provider is doing business as Deaconess Illinois Clinic.

Where is Deaconess Illinois Clinic, Inc located?

Deaconess Illinois Clinic, Inc is located at 205 S Burns Ave, Sparta, IL 62286. The listed phone number is (618) 443-2858.

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.