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DEACONESS ILLINOIS SPECIALTY CLINIC INC. NPI 1447965751


NPI Information

NPI: 1447965751
Provider Name: DEACONESS ILLINOIS SPECIALTY CLINIC, INC.

Doing Business As: DEACONESS IL SPECIALTY EXPRESS 909 W MAIN ST

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2283001

Address:
909 W MAIN ST STE 2
WEST FRANKFORT, IL
ZIP 62896
Phone: (812) 450-6815
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DEACONESS ILLINOIS SPECIALTY CLINIC, INC. is a family medicine in West Frankfort, 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 SPECIALTY CLINIC, INC. NPI is 1447965751. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Deaconess Il Specialty Express 909 W Main St.

The provider's business location address is:

909 W MAIN ST STE 2
WEST FRANKFORT, IL
ZIP 62896-209
Phone: (812) 450-6815
Fax: (812) 450-6822

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 CLIA number assigned to this NPI record is 14D2283001 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/20/2023 and was last updated on 1/20/2023.


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
1207K00000XAllergy & ImmunologyNo
2207Q00000XFamily 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: 5/5/2024

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