DEACONESS IL SPECIALTY KIRKWOOD
NPI 1386351849
Internal Medicine - Interventional Cardiology in Saint Louis, MO

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, 2022

1028 S KIRKWOOD RD, SAINT LOUIS, MO 63122(314) 287-6184(314) 394-2253 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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

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About Deaconess Il Specialty Kirkwood NPPES

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

DEACONESS IL SPECIALTY KIRKWOOD (NPI 1386351849) is a healthcare organization registered as an interventional cardiology in Saint Louis, Missouri and active in the NPI registry since November 2022. The organization lists Kyle Dillman, Secretary Treasurer, as its authorized official.

NPPES Registry Identity

NPI1386351849

Entity TypeOrganization

Primary Taxonomy207RI0011X

Legal Business NameDEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Location Address1028 S KIRKWOOD RDSaint Louis, MO 63122-7222

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

Phone(314) 287-6184

Fax(314) 394-2253

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 1386351849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedNurse PractitionerTaxonomy 363L00000X

1028 S KIRKWOOD RD, Saint Louis, MO 63122

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Other Names 2

Doing Business AsDeaconess Il Specialty Kirkwood

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

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 Specialty Kirkwood is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Deaconess Il Specialty Kirkwood, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Matthew Jones, ACNP

Nurse Practitioner

NPI 1093055402

509 HAMACHER ST STE 202
Waterloo, IL 62298

(618) 939-4200

✔ PECOS21 mi

William Reilly, M.D.

Cardiovascular Disease (Cardiology)

NPI 1205846516

509 HAMACHER ST STE 204
Waterloo, IL 62298

(618) 939-4200

✔ PECOS✔ Accepts Medicare21 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 1386351849. It was assigned to this organization in the NPPES registry on November 3, 2022. The provider is doing business as Deaconess Il Specialty Kirkwood and St. Louis Cardiovascular.

Where is Deaconess Illinois Specialty Clinic, Inc. located?

Deaconess Illinois Specialty Clinic, Inc. is located at 1028 S Kirkwood Rd, Saint Louis, MO 63122. The listed phone number is (314) 287-6184.

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.

Is Deaconess Illinois Specialty Clinic, Inc. enrolled in Medicare?

Yes. Deaconess Illinois Specialty Clinic, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Deaconess Illinois Specialty Clinic, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Deaconess Illinois Specialty Clinic, Inc., in Cardiovascular Disease (Cardiology) and Nurse Practitioner. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.