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DEACONESS IL CLINIC BAILEY LN
NPI 1790401081
Family Medicine in Benton, IL

Active since October 18, 2022CLIA 14D2335935 · Waiver
205 BAILEY LN STE F, BENTON, IL 62812(618) 882-4200(618) 882-4208 Get Directions Write a Review

NPPES record last updated: January 26, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 26, 2023, Dec 2, 2022, Oct 18, 2022 (3 updates tracked since 2022).

About Deaconess Il Clinic Bailey Ln NPPES

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

DEACONESS IL CLINIC BAILEY LN (NPI 1790401081) is a healthcare organization registered as a family medicine in Benton, Illinois and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through December 18, 2027 and lists Kyle Dillman, Secretary, as its authorized official.

NPPES Registry Identity

NPI1790401081
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDEACONESS ILLINOIS CLINIC, INC
Location Address205 BAILEY LN STE FBenton, IL 62812-1921
Mailing AddressPo Box 34156Belfast, ME 04915-0619 · (812) 450-6815 · Fax (812) 450-6822
Phone(618) 882-4200
Fax(618) 882-4208
Organization SubpartNo
Authorized OfficialKyle DillmanSecretary · (812) 450-7399
Enumeration DateOctober 18, 2022
Last NPPES UpdateJanuary 26, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2023
✔ NPI 1790401081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedNurse PractitionerTaxonomy 363L00000X
205 BAILEY LN STE F, Benton, IL 62812
Open in Google Maps ↗

Other Names 1

Doing Business AsDeaconess Il Clinic Bailey Ln

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

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 14D2335935

Deaconess Illinois Clinic Gi & Family Medicine · Benton, IL
Active · expires Dec 18, 2027
CLIA Number14D2335935
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 19, 2025
Certificate Expiration DateDecember 18, 2027
Laboratory DirectorKara Tipsword
Laboratory Phone(618) 882-4200
Laboratory LocationDeaconess Illinois Clinic Gi & Family Medicine205 Bailey Lane - Ste F, Benton, IL 62812
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Clinic/Center (Rural Health)
205 BAILEY LN STE F
BENTON, IL 62812
Franklin County (618) 918-0645
NATIONAL HEALTHCARE OF MT VERNON INC
Clinic/Center (Rural Health)
205 BAILEY LN STE F
BENTON, IL 62812
Franklin County (618) 882-4200
DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
Orthopaedic Surgery
205 BAILEY LN STE F
BENTON, IL 62812
Franklin County (618) 882-4200

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 1790401081. It was assigned to this organization in the NPPES registry on October 18, 2022. The provider is doing business as Deaconess Il Clinic Bailey Ln.

Where is Deaconess Illinois Clinic, Inc located?

Deaconess Illinois Clinic, Inc is located at 205 Bailey Ln Ste F, Benton, IL 62812. The listed phone number is (618) 882-4200.

What is Deaconess Illinois Clinic, Inc's specialty?

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

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

Yes. A Certificate of Waiver (number 14D2335935) is associated with this NPI, valid through December 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deaconess Illinois Clinic, Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Deaconess Illinois Clinic, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Deaconess Illinois 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.