DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
NPI 1225858251
Hospitalist in Anna, IL

NPI Status: Active since October 15, 2024

Contact Information

517 N MAIN ST
ANNA, IL
ZIP 62906
Phone: (618) 833-4511

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

About DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

This page provides the complete NPI Profile along with additional information for Deaconess Illinois Specialty Clinic, Inc., a provider established in Anna, Illinois operating as a Hospitalist. The healthcare provider is registered in the NPI registry with number 1225858251 assigned on October 2024. The practitioner's primary taxonomy code is 208M00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Deaconess Illinois Specialty Clinic, Inc. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Kyle Dillman (Secretary)

NPI
1225858251
Provider Name
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Entity Type
Organization
Location Address
517 N MAIN ST ANNA, IL 62906
Location Phone
(618) 833-4511
Mailing Address
PO BOX 632331 CINCINNATI, OH 45263
Mailing Phone
(618) 833-4511
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-15-2024
Last Update Date
10-15-2024
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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

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

 
2363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas 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
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 Illinois Specialty Clinic, Inc. 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 1225858251, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

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
2
Unchanged
Pos 3
2
Doubled → 4
Pos 4
5
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
2
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
1
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 2 → 4 8 → 16 → 7 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 4 + 5 + 1 + 6 + 5 + 1 + 6 + 2 + 1 + 0 + 24 = 59

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

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1225858251.

Other Providers at the Same Location


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

Home Health
517 N MAIN ST
ANNA, IL 62906
Emergency Medicine
517 N MAIN ST
ANNA, IL 62906
Physical Therapist
517 N MAIN ST
ANNA, IL 62906
Emergency Medicine
517 N MAIN ST
ANNA, IL 62906
Family Medicine
517 N MAIN ST
ANNA, IL 62906
Nurse Practitioner (Family)
517 N MAIN ST
ANNA, IL 62906
Pharmacy
517 N MAIN ST
ANNA, IL 62906
Physician Assistant
517 N MAIN ST
ANNA, IL 62906
Medicare Defined Swing Bed Unit
517 N MAIN ST
ANNA, IL 62906
General Acute Care Hospital (Critical Access)
517 N MAIN ST
ANNA, IL 62906
Nurse Anesthetist, Certified Registered
517 N MAIN ST
ANNA, IL 62906
Nurse Practitioner
517 N MAIN ST
ANNA, IL 62906
Family Medicine
517 N MAIN ST
ANNA, IL 62906
Clinic/Center (Rural Health)
517 N MAIN ST
ANNA, IL 62906
Pharmacist
517 N MAIN ST
ANNA, IL 62906
Nurse Practitioner (Family)
517 N MAIN ST
ANNA, IL 62906
Physical Therapist
517 N MAIN ST
ANNA, IL 62906
Occupational Therapist
517 N MAIN ST
ANNA, IL 62906
General Acute Care Hospital (Critical Access)
517 N MAIN ST
ANNA, IL 62906
Physical Therapy Assistant
517 N MAIN ST
ANNA, IL 62906

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1225858251, enumerated as an "organization" on October 15, 2024.

The provider is located at 517 N MAIN ST ANNA, IL 62906 and the phone number is (618) 833-4511.

Hospitalist with taxonomy code 208M00000X.