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

Deaconess Illinois Clinic, Inc

Organization Family Medicine Physician · NPI 1962128256

Deaconess Illinois Clinic, Inc is a Family Medicine Physician in Columbia, 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.

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Practice location Address checks out

1000 Eleven S Ste 2E
Columbia, IL 62236-1079
Phone: (618) 281-2773
Fax: (618) 281-0245
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1962128256
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary / Treasurer · (812) 450-7399
Other names Deaconess Il Clinic Eleven S; Family Practice Associates
NPI enumeratedOctober 18, 2022
Last updated in NPPESJanuary 26, 2023
Certification dateJanuary 26, 2023
Mailing addressPo Box 34156, Belfast, ME 04915-0619

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