DEACONESS IL CLINIC 303 COMMERCIAL ST
NPI 1285350504
Family Medicine in Harrisburg, IL
About Deaconess Il Clinic 303 Commercial St NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEACONESS IL CLINIC 303 COMMERCIAL ST (NPI 1285350504) is a healthcare organization registered as a family medicine in Harrisburg, Illinois and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through February 22, 2027 and lists Kyle Dillman, Secretary Treasurer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Deaconess Il Clinic 303 Commercial St is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
29Medicare enrollment records show 29 clinicians reassign Medicare billing to Deaconess Il Clinic 303 Commercial St, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 29Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 14D2277265
Deaconess Il Clinic · Harrisburg, ILFrequently 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 1285350504. It was assigned to this organization in the NPPES registry on October 18, 2022. The provider is doing business as Deaconess Il Clinic 303 Commercial St.
Where is Deaconess Illinois Clinic, Inc located?
Deaconess Illinois Clinic, Inc is located at 303 S Commercial St, Harrisburg, IL 62946. The listed phone number is (618) 918-6060.
What is Deaconess Illinois Clinic, Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Deaconess Illinois Clinic, Inc enrolled in Medicare?
Yes. Deaconess Illinois Clinic, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Deaconess Illinois Clinic, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 29 clinicians in 5 Medicare specialties reassign their Medicare billing to Deaconess Illinois Clinic, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (18), Family Practice (8) and Emergency Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Deaconess Illinois Clinic, Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D2277265) is associated with this NPI, valid through February 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Deaconess Illinois Clinic, Inc was last updated on July 28, 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.
# Deaconess Il Clinic 303 Commercial St · NPI 1285350504
Family Medicine organization in Harrisburg, Illinois. Organization record, active in the CMS NPPES registry since October 18, 2022.
## Identity
- **NPI:** 1285350504 (Entity type: Organization)
- **Enumerated:** October 18, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Deaconess Illinois Clinic, Inc
- **Organization subpart:** No
- **Authorized official:** Kyle Dillman, SECRETARY TREASURER
## Practice location
- **Address:** 303 S COMMERCIAL ST, Harrisburg, IL 62946-2125
- **Phone:** (618) 918-6060 · **Fax:** (618) 294-8238
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 29 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (18), Family Practice (8), Emergency Medicine (1); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1285350504/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 28, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1285350504) · Data from the CMS NPPES public registry.