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

Deaconess Illinois Clinic, Inc

Organization Family Medicine Physician · NPI 1063128544

Deaconess Illinois Clinic, Inc provides Family Medicine Physician services 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

4105 N Water Tower Pl
Mount Vernon, IL 62864-6296
Phone: (812) 450-6815
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1063128544
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary · (812) 450-7399
Other names Deaconess Il Clinic 4105 N Water Tower
NPI enumeratedJanuary 27, 2023
Last updated in NPPESJanuary 27, 2023
Certification dateJanuary 20, 2023
Mailing addressPo Box 34156, Belfast, ME 04915-0619

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