Deaconess Illinois Specialty Clinic, INC.
Family Medicine in West Frankfort, IL. Organization (NPI-2).
NPI number1447965751
StatusActive
Last updated in NPPESJan 20, 2023
Details
- NPI
- 1447965751
- Entity type
- Organization (NPI-2)
- Legal business name
- Deaconess Illinois Specialty Clinic, INC.
- Organization subpart
- No
- Enumeration date
- Jan 20, 2023
- Certification date
- Jan 20, 2023
- Last updated
- Jan 20, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207K00000X | Allergy & Immunology | – | – |
Other names
- Deaconess Il Specialty Express 909 W Main St (Doing Business As)
Practice location
909 W Main St Ste 2West Frankfort, IL 62896-2209
Phone 812-450-6815 · Fax 812-450-6822
Mailing address
Po Box 34266Belfast, ME 04915-0620
Phone 812-450-6815 · Fax 812-450-6822
Authorized official
Kyle Dillman
Secretary
8124507399
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