DEACONESS ILLINOIS CLINIC INC NPI 1619684362

NPI Information

  • NPI: 1619684362
  • Provider Name: DEACONESS ILLINOIS CLINIC, INC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: DEACONESS ILLINOIS CLINIC
  • CLIA Number: 15D0968542
  • Address: 3331 W DEYOUNG ST
    MARION, IL
    ZIP 62959
  • Phone: (812) 450-6815

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NPI Details

DEACONESS ILLINOIS CLINIC, INC is a family medicine in Marion, 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 1619684362. 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:

3331 W DEYOUNG ST
MARION, IL
ZIP 62959-896
Phone: (812) 450-6815

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 CLIA number assigned to this NPI record is 15D0968542 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2022 and was last updated on 1/19/2023.

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
12083X0100XPreventive MedicineOccupational MedicineNo
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: 11/21/2025

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