DEACONESS IL SPECIALTY HAMACHER ST
NPI 1336856806
Internal Medicine - Interventional Cardiology in Waterloo, IL

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Active since November 03, 2022CLIA 14D0434529 · Waiver

509 HAMACHER ST, WATERLOO, IL 62298(618) 939-4200(618) 939-4256 Get Directions Write a Review

NPPES record last updated: June 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 7, 2023, Jan 26, 2023, Dec 2, 2022 and 2 more (5 updates tracked since 2022).

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About Deaconess Il Specialty Hamacher St NPPES

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

DEACONESS IL SPECIALTY HAMACHER ST (NPI 1336856806) is a healthcare organization registered as an interventional cardiology in Waterloo, Illinois and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through February 15, 2028 and lists Kyle Dillman, Secretary Treasurer, as its authorized official.

NPPES Registry Identity

NPI1336856806

Entity TypeOrganization

Primary Taxonomy207RI0011X

Legal Business NameDEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Location Address509 HAMACHER STWaterloo, IL 62298-1592

Mailing AddressPo Box 34266Belfast, ME 04915-0620 · (812) 450-6815 · Fax (812) 450-6822

Phone(618) 939-4200

Fax(618) 939-4256

Organization SubpartNo

Authorized OfficialKyle DillmanSecretary Treasurer · (812) 450-7399

Enumeration DateNovember 3, 2022

Last NPPES UpdateJune 7, 20235 updates tracked since enumeration

NPPES CertifiedJune 7, 2023

✔ NPI 1336856806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RI0011X

Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

509 HAMACHER ST, Waterloo, IL 62298

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Other Names 2

Doing Business AsDeaconess Il Specialty Hamacher St

Doing Business AsSt. Louis Cardiovascular

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

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 14D0434529

Deaconess Illinois Clinic · Waterloo, IL

Active · expires Feb 15, 2028

CLIA Number14D0434529

Laboratory TypePhysician Office

Certificate Effective DateFebruary 16, 2026

Certificate Expiration DateFebruary 15, 2028

Laboratory DirectorShanna Wigtes

Laboratory Phone(618) 939-3939

Laboratory LocationDeaconess Illinois Clinic509 Hamacher St, Ste 102, Waterloo, IL 62298

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

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

KERRI DOCKINS-HALL PT

Physical Therapist

509 HAMACHER ST, STE 101
WATERLOO, IL 62298

Monroe County (618) 939-5555

ELISHA F SCHNIEDERS CPNP

Nurse Practitioner (Pediatrics)

509 HAMACHER ST, SUITE 103
WATERLOO, IL 62298

Monroe County (618) 939-2273

SOUTHERN ILLINOIS CENTER FOR HEALTH

Family Medicine

509 HAMACHER ST
WATERLOO, IL 62298

Monroe County (618) 939-3939

SOUTHERN ILLINOIS IMAGING ASSOCIATES, LLC

Radiology (Diagnostic Radiology)

509 HAMACHER ST, SUITE 300
WATERLOO, IL 62298

Monroe County (618) 939-9790

FOOT & ANKLE CENTER, LLC

Podiatrist (Foot & Ankle Surgery)

509 HAMACHER ST, SUITE 202
WATERLOO, IL 62298

Monroe County (618) 939-5979

PARKCREST ORTHOPEDICS LLC

Orthopaedic Surgery

509 HAMACHER ST, STE 202
WATERLOO, IL 62298

Monroe County (314) 997-1777

ASSOCIATED PHYSICIANS GROUP LTD

Physician Assistant

509 HAMACHER ST, SUITE 202
WATERLOO, IL 62298

Monroe County (618) 939-5979

NICHOLE E FRIEDERICH DPT

Physical Therapist

509 HAMACHER ST, SUITE 101
WATERLOO, IL 62298

Monroe County (618) 939-5555

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 1336856806. It was assigned to this organization in the NPPES registry on November 3, 2022. The provider is doing business as Deaconess Il Specialty Hamacher St and St. Louis Cardiovascular.

Where is Deaconess Illinois Specialty Clinic, Inc. located?

Deaconess Illinois Specialty Clinic, Inc. is located at 509 Hamacher St, Waterloo, IL 62298. The listed phone number is (618) 939-4200.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

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

Yes. A Certificate of Waiver (number 14D0434529) is associated with this NPI, valid through February 15, 2028. 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 Specialty Clinic, Inc. was last updated on June 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.