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

Deaconess Illinois Specialty Clinic, Inc

Organization Family Medicine Physician · NPI 1922715408

Deaconess Illinois Specialty Clinic, Inc is a Family Medicine Physician in Red Bud, Illinois. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
7
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

350 W South 1st St
Red Bud, IL 62278-1116
Phone: (618) 282-7373
Fax: (618) 282-7376
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Interventional Cardiology Physician Taxonomy 207RI0011X
Surgery Physician Taxonomy 208600000X
Urology Physician Taxonomy 208800000X
Pain Medicine Physician Taxonomy 208VP0000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1922715408
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary Treasurer · (812) 450-7399
Other names Deaconess Il Specialty Spring St Multispecialty; St. Louis Cardiovascular
NPI enumeratedNovember 3, 2022
Last updated in NPPESJune 29, 2023
Certification dateJune 29, 2023
Mailing addressPo Box 34266, Belfast, ME 04915-0620

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