Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Deaconess Illinois Clinic, Inc

Organization Family Medicine Physician · NPI 1114644747

Deaconess Illinois Clinic, Inc is a Family Medicine Physician in Mount Vernon, Illinois. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4113 S Water Tower Pl
Mount Vernon, IL 62864-6293
Phone: (618) 241-9071
Fax: (618) 241-9079
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1114644747
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary / Treasurer · (812) 450-7399
Other names Deaconess Illinois Clinic; Deaconess Illinois Clinic
NPI enumeratedOctober 25, 2022
Last updated in NPPESDecember 2, 2022
Certification dateDecember 2, 2022
Mailing addressPo Box 34156, Belfast, ME 04915-0619

Other providers in Mount Vernon