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

Deaconess Illinois Specialty Clinic, Inc

Organization Occupational Health Nurse Practitioner · NPI 1679270763

Deaconess Illinois Specialty Clinic, Inc is an Occupational Health Nurse Practitioner in Mount Vernon, Illinois. Registered with an NPI since 2023.

In the registry since
2023
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

3111 Broadway St
Mount Vernon, IL 62864-2338
Phone: (618) 241-0333
Fax: (618) 241-0334
Show map & directions

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

Specialties & licences

Occupational Health Nurse Practitioner (primary) Taxonomy 363LX0106X

Record details

NPI number1679270763
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary · (812) 450-7399
Other names Deaconess Illinois Specialty Clinic Occupational Health Broadway
NPI enumeratedFebruary 9, 2023
Last updated in NPPESFebruary 9, 2023
Certification dateFebruary 9, 2023
Mailing address3111 Broadway St, Mount Vernon, IL 62864-2338