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

Deaconess Illinois Specialty Clinic, Inc

Organization Family Medicine Physician · NPI 1295442556

Deaconess Illinois Specialty 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
Cardiovascular Disease Physician Taxonomy 207RC0000X
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X
Gastroenterology Physician Taxonomy 207RG0100X
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 number1295442556
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary Treasurer · (812) 450-7399
Other names Deaconess Il Specialty Crossroads Pl; River To River Heart Group
NPI enumeratedNovember 4, 2022
Last updated in NPPESJanuary 26, 2023
Certification dateJanuary 26, 2023
Mailing addressPo Box 34266, Belfast, ME 04915-0620

Other providers in Mount Vernon