DEACONESS ILLINOIS CLINIC
NPI 1407572860
Surgery in Marion, IL
NPI Status: Active since October 18, 2022
Contact Information
3331 W DEYOUNG ST
MARION, IL
ZIP 62959
Phone: (618) 998-7600
Fax: (618) 997-6680
- Organization
- Surgery
- CLIA Number: 14D1021062
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-11-2028
About DEACONESS ILLINOIS CLINIC
This page provides the complete NPI Profile along with additional information for Deaconess Illinois Clinic, a provider established in Marion, Illinois operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1407572860 assigned on October 2022. The practitioner's primary taxonomy code is 208600000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Deaconess Illinois Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Deaconess Illinois Clinic. The authorized official of this NPI record is Kyle Dillman (Secretary / Treasurer)
- NPI
- 1407572860
- Provider Legal Name
- DEACONESS ILLINOIS CLINIC, INC
- Other Organization Name
- DEACONESS ILLINOIS CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3331 W DEYOUNG ST MARION, IL 62959
- Location Phone
- (618) 998-7600
- Location Fax
- (618) 997-6680
- Mailing Address
- PO BOX 34156 BELFAST, ME 04915
- Mailing Phone
- (812) 450-6815
- Mailing Fax
- (618) 997-6680
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-18-2022
- Last Update Date
- 12-02-2022
- Code Navigator
A surgeon like Deaconess Illinois Clinic treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
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
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
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) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 5 | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 6 | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 7 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 8 | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | |
| 9 | 208800000X | Allopathic & Osteopathic Physicians | Urology | |
| 10 | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | |
| 11 | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | |
| 12 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 13 | 363L00000X | Physician 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.
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
- 14D1021062
- Facility Type
- Physician Office
- Certificate Effective Date
- January 12, 2026
- Certificate Expiration Date
- January 11, 2028
- Laboratory Director
- VICTOR MWANSA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Deaconess Illinois Clinic 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 1407572860, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
MARION, IL 62959
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407572860, enumerated as an "organization" on October 18, 2022.
The provider is located at 3331 W DEYOUNG ST MARION, IL 62959 and the phone number is (618) 998-7600.
Surgery with taxonomy code 208600000X.
