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DEACONESS ILLINOIS SPECIALTY CLINIC INC. NPI 1154036259


NPI Information

NPI: 1154036259
Provider Name: DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Doing Business As: DEACONESS IL SPECIALTY CLINIC OCCUPATIONAL HEALTH

Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
3331 W DEYOUNG ST STE 101
MARION, IL
ZIP 62959
Phone: (618) 998-7169
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DEACONESS ILLINOIS SPECIALTY CLINIC, INC. is a nurse practitioner in Marion, IL. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. DEACONESS ILLINOIS SPECIALTY CLINIC, INC. NPI is 1154036259. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deaconess Il Specialty Clinic Occupational Health.

The provider's business location address is:

3331 W DEYOUNG ST STE 101
MARION, IL
ZIP 62959-896
Phone: (618) 998-7169
Fax: (618) 998-7533

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

The enumeration date for this NPI number is 1/23/2023 and was last updated on 1/26/2023.


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
1364SX0106XClinical Nurse SpecialistOccupational HealthNo
2363L00000XNurse PractitionerYes

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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