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Deaconess Illinois Clinic, Inc

Family Medicine Physician in Mount Vernon, IL · enumerated 2022 · authorized official Kyle Dillman, Secretary / Treasurer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1558088138

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Registry record

Entity type Organization (Type 2)
Legal business name Deaconess Illinois Clinic, Inc
Other name <Unavail>
Practice address 3111 Broadway St, Mount Vernon, IL, 62864
Phone (618) 241-0300
Fax (618) 241-0302
Enumeration date Oct 24, 2022
Last updated in NPPES Dec 2, 2022

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
207QS0010X Sports Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians Secondary
363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Kyle Dillman
Title Secretary / Treasurer
Phone (812) 450-7399

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Deaconess Illinois Clinic, Inc?
The NPI for Deaconess Illinois Clinic, Inc is 1558088138, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Deaconess Illinois Clinic, Inc?
NPPES lists Kyle Dillman (Secretary / Treasurer) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-12-02.