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 1801513577

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
9
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

209 Crossroads Pl
Mount Vernon, IL 62864-6545
Phone: (618) 244-1937
Fax: (618) 241-9079
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Gastroenterology Physician Taxonomy 207RG0100X
Nephrology Physician Taxonomy 207RN0300X
Pulmonary Disease Physician Taxonomy 207RP1001X
Surgery Physician Taxonomy 208600000X
Urology Physician Taxonomy 208800000X
Colon & Rectal Surgery Physician Taxonomy 208C00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1801513577
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 24, 2022
Last updated in NPPESDecember 2, 2022
Certification dateDecember 2, 2022
Mailing addressPo Box 34156, Belfast, ME 04915-0619

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