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DEACONESS ILLINOIS CLINIC INC NPI 1366169997


NPI Information

NPI: 1366169997
Provider Name: DEACONESS ILLINOIS CLINIC, INC

Doing Business As: DEACONESS ILLINOIS CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
515 N MAIN ST
ANNA, IL
ZIP 62906
Phone: (618) 833-4511
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DEACONESS ILLINOIS CLINIC, INC is a family medicine in Anna, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DEACONESS ILLINOIS CLINIC, INC NPI is 1366169997. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Illinois Clinic.

The provider's business location address is:

515 N MAIN ST
ANNA, IL
ZIP 62906-668
Phone: (618) 833-4511
Fax: (618) 833-2414

The provider's authorized official is Kyle Dillman .
The authorized official title is Secretary / Treasurer and has the following contact phone number (812) 450-7399.

The enumeration date for this NPI number is 10/25/2022 and was last updated on 12/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryNo
2363L00000XNurse PractitionerNo
3207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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