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

Deaconess Illinois Clinic, Inc

Organization Family Medicine Physician · NPI 1245956523

Deaconess Illinois Clinic, Inc provides Family Medicine Physician services in Mount Vernon, Illinois. Registered with an NPI since 2022.

In the registry since
2022
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

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone: (812) 450-6815
Fax: (812) 450-6822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1245956523
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyle Dillman — Secretary / Treasurer · (812) 450-7399
Other names Deaconess Illinois Clinic; Deaconess Illinois Clinic
NPI enumeratedOctober 18, 2022
Last updated in NPPESDecember 2, 2022
Certification dateDecember 2, 2022
Mailing addressPo Box 34156, Belfast, ME 04915-0619

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