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DEACONESS ILLINOIS CLINIC
NPI 1558088138
Family Medicine in Mount Vernon, IL

Active since October 24, 2022
3111 BROADWAY ST, MOUNT VERNON, IL 62864(618) 241-0300(618) 241-0302 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 2, 2022, Oct 24, 2022 (2 updates tracked since 2022).

About Deaconess Illinois Clinic NPPES

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

DEACONESS ILLINOIS CLINIC (NPI 1558088138) is a healthcare organization registered as a family medicine in Mount Vernon, Illinois and active in the NPI registry since October 2022. The organization lists Kyle Dillman, Secretary / Treasurer, as its authorized official.

NPPES Registry Identity

NPI1558088138
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEACONESS ILLINOIS CLINIC, INC
Location Address3111 BROADWAY STMount Vernon, IL 62864-2338
Mailing AddressPo Box 34156Belfast, ME 04915-0619 · (812) 450-6815 · Fax (812) 450-6822
Phone(618) 241-0300
Fax(618) 241-0302
Organization SubpartNo
Authorized OfficialKyle DillmanSecretary / Treasurer · (812) 450-7399
Enumeration DateOctober 24, 2022
Last NPPES UpdateDecember 2, 20222 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
✔ NPI 1558088138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
Also ListedNurse PractitionerTaxonomy 363L00000X
3111 BROADWAY ST, Mount Vernon, IL 62864
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Other Names 1

Doing Business AsDeaconess Illinois Clinic

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

Other Providers at the Same Location NPPES 4

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

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Nurse Practitioner
3111 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 241-0300
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Nurse Practitioner (Occupational Health)
3111 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 241-0333
BRIDGETT NICOLE BROWN FNP-C
Nurse Practitioner
3111 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 241-0333
BRITTANY MCDONALD APRN
Nurse Practitioner
3111 BROADWAY ST
MOUNT VERNON, IL 62864
Jefferson County (618) 241-0300

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 Clinic, Inc's NPI number?

The NPI number for Deaconess Illinois Clinic, Inc is 1558088138. It was assigned to this organization in the NPPES registry on October 24, 2022. The provider is doing business as Deaconess Illinois Clinic.

Where is Deaconess Illinois Clinic, Inc located?

Deaconess Illinois Clinic, Inc is located at 3111 Broadway St, Mount Vernon, IL 62864. The listed phone number is (618) 241-0300.

What is Deaconess Illinois Clinic, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Deaconess Illinois Clinic, Inc was last updated on December 2, 2022. 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.