DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
NPI 1972210235
Surgery in Marion, IL

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

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since November 04, 2022

3331 W DEYOUNG ST, MARION, IL 62959(618) 998-7155(618) 998-7285 Get Directions Write a Review

NPPES record last updated: May 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 23, 2026, Aug 7, 2023, Jan 26, 2023 and 3 more (6 updates tracked since 2022).

On this page

About Deaconess Illinois Specialty Clinic, Inc. NPPES

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

DEACONESS ILLINOIS SPECIALTY CLINIC, INC. (NPI 1972210235), doing business as Deaconess Il Specialty 3331 Deyoung, is a healthcare organization registered as a surgery in Marion, Illinois and active in the NPI registry since November 2022. The organization lists Kyle Dillman, Secretary Treasurer, as its authorized official.

NPPES Registry Identity

NPI1972210235

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NameDEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Location Address3331 W DEYOUNG STMarion, IL 62959-5896

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

Phone(618) 998-7155

Fax(618) 998-7285

Organization SubpartNo

Authorized OfficialKyle DillmanSecretary Treasurer · (812) 450-7399

Enumeration DateNovember 4, 2022

Last NPPES UpdateMay 23, 20266 updates tracked since enumeration

NPPES CertifiedMay 23, 2026

✔ NPI 1972210235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Definition

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.

Also ListedSpecialistTaxonomy 174400000X

Also ListedAllergy & ImmunologyTaxonomy 207K00000X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X

Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X

Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X

Also ListedUrologyTaxonomy 208800000X

Also ListedColon & Rectal SurgeryTaxonomy 208C00000X

Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

3331 W DEYOUNG ST, Marion, IL 62959

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Other Names 3

Doing Business AsDeaconess Il Specialty 3331 Deyoung

Doing Business AsRiver To River Heart Group

Doing Business AsSouthern Illinois Vein 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

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

Clinicians Billing Medicare Through This Organization

227

Medicare enrollment records show 227 clinicians reassign Medicare billing to Deaconess Illinois Specialty Clinic, Inc., which bills Medicare for the services they deliver. Of these, 6 practice at this address and 42 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 29

Nurse Practitioner56

Family Practice26

Internal Medicine24

Emergency Medicine19

Hospitalist16

Gastroenterology11

General Surgery9

Urology9

21 other specialties57

Nearest to this location (20)

See all 227

Antoinette Miller, NP

Nurse Practitioner

NPI 1053854729

3331 W DEYOUNG ST STE 301
Marion, IL 62959

(618) 998-7239

✔ PECOS✔ Accepts MedicareSame address

Wasey Ali Yadullahi Mir, MD

Pulmonary Disease

NPI 1972098804

3331 W DEYOUNG ST STE 109
Marion, IL 62959

(618) 998-7961

✔ PECOS✔ Accepts MedicareSame address

Amar Rawal, MD

Urology

NPI 1538591268

3331 W DEYOUNG ST
Marion, IL 62959

(618) 998-8884

✔ PECOS✔ Accepts MedicareSame address

Marie Gorski, MD

General Surgery

NPI 1841374873

3331 W DEYOUNG ST STE 305
Marion, IL 62959

(618) 998-7155

✔ PECOS✔ Accepts MedicareSame address

Amar Mukerji, MD, MS

General Surgery

NPI 1750624045

3331 W DEYOUNG ST STE 305
Marion, IL 62959

(618) 998-7155

✔ PECOS✔ Accepts MedicareSame address

Victor Mwansa, M.D

Cardiovascular Disease (Cardiology)

NPI 1811194244

3331 W DEYOUNG ST SUITE 100
Marion, IL 62959

(618) 998-7600

✔ PECOS✔ Accepts MedicareSame address

Michelle Mc Lain, APN

Nurse Practitioner

NPI 1104102474

3333 W DEYOUNG ST
Marion, IL 62959

(618) 998-7947

✔ PECOSSame address

Qiong Qiu, M.D.

General Surgery

NPI 1629422340

3333 W DEYOUNG ST
Marion, IL 62959

(618) 998-7155

✔ PECOS✔ Accepts MedicareSame address

Joshua Richardson, FNP-C

Nurse Practitioner

NPI 1306322136

3333 W DEYOUNG ST
Marion, IL 62959

(618) 998-7000

✔ PECOS✔ Accepts MedicareSame address

Zaid Al-Dahabrah, MD

Nephrology

NPI 1174194039

3333 W DEYOUNG ST
Marion, IL 62959

(618) 998-7000

✔ PECOS✔ Accepts Medicare0.1 mi

Racheal Mcvicker, NP

Nurse Practitioner

NPI 1528856325

3333 W DEYOUNG ST
Marion, IL 62959

(618) 997-2161

✔ PECOS✔ Accepts Medicare0.1 mi

Mitchell Cook, D.P.M.

Podiatry

NPI 1285920835

3329 W DEYOUNG ST
Marion, IL 62959

(618) 767-6050

✔ PECOS✔ Accepts Medicare0.3 mi

Dietra Angelly, FNP-C

Nurse Practitioner

NPI 1902371313

3411 PROFESSIONAL PARK DR
Marion, IL 62959

(618) 969-8630

✔ PECOS✔ Accepts Medicare0.5 mi

Robin Dailey

Nurse Practitioner

NPI 1265893051

3411 PROFESSIONAL PARK DR
Marion, IL 62959

(618) 997-2161

✔ PECOS✔ Accepts Medicare0.5 mi

Kalinda Dunning

Nurse Practitioner

NPI 1851961635

3411 PROFESSIONAL PARK DR
Marion, IL 62959

(618) 969-8630

✔ PECOS✔ Accepts Medicare0.5 mi

Jodi Fox, M.D.

Family Practice

NPI 1508848284

3411 PROFESSIONAL PARK DR
Marion, IL 62959

(618) 997-2161

✔ PECOS✔ Accepts Medicare0.5 mi

Nicole Kennedy, MD

Family Practice

NPI 1780902486

3411 PROFESSIONAL PARK DRIVE SIMCA
Marion, IL 62959

(618) 997-2161

✔ PECOS✔ Accepts Medicare0.5 mi

Heather Alexander, FNP-BC

Nurse Practitioner

NPI 1992439293

2700 W DEYOUNG ST STE F
Marion, IL 62959

(618) 998-7000

✔ PECOS✔ Accepts Medicare1.4 mi

Mack Mccain, M.D.

Gastroenterology

NPI 1558321190

404 LINCOLN DR
Herrin, IL 62948

(618) 993-0056

✔ PECOS✔ Accepts Medicare2.0 mi

Alejandro Hornik

Neurology

NPI 1134384977

3309 LOGAN DR
Herrin, IL 62948

(615) 549-1882

✔ PECOS✔ Accepts Medicare2.1 mi

See all 227 clinicians

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 1972210235. It was assigned to this organization in the NPPES registry on November 4, 2022. The provider is doing business as Deaconess IL Specialty 3331 DeYoung, River to River Heart Group and Southern Illinois Vein Clinic.

Where is Deaconess Illinois Specialty Clinic, Inc. located?

Deaconess Illinois Specialty Clinic, Inc. is located at 3331 W Deyoung St, Marion, IL 62959. The listed phone number is (618) 998-7155.

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

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

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), 227 clinicians in 29 Medicare specialties reassign their Medicare billing to Deaconess Illinois Specialty Clinic, Inc.. 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. The largest specialties are Nurse Practitioner (56), Family Practice (26) and Internal Medicine (24). Of these, 6 practice at this address and 42 within 10 miles. 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 May 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.