Deaconess Illinois Specialty Clinic, Inc.
NPI 1003523374 · Family Medicine Physician · Mount Vernon, IL
Deaconess Illinois Specialty Clinic, Inc. is a Family Medicine Physician organization in Mount Vernon, IL (NPI 1003523374).
Provider details
- NPI number
- 1003523374
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kyle Dillman, Secretary Treasurer(812) 450-7399
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Otolaryngology Physician207Y00000X
Allopathic & Osteopathic Physicians
- Audiologist231H00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Deaconess Il Specialty 4117 Water Tower
Registry dates
- Enumerated
- 2022-11-04
- Last updated
- 2023-01-26
- Certified
- 2023-01-26
Frequently asked questions
- What is Deaconess Illinois Specialty Clinic, Inc.'s NPI number?
- Deaconess Illinois Specialty Clinic, Inc.'s National Provider Identifier (NPI) is 1003523374, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Deaconess Illinois Specialty Clinic, Inc.?
- Deaconess Illinois Specialty Clinic, Inc. is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Deaconess Illinois Specialty Clinic, Inc. located?
- Deaconess Illinois Specialty Clinic, Inc.'s practice location on file with NPPES is 4117 S Water Tower Pl Ste C, Mount Vernon, IL 62864-6567.
- What is Deaconess Illinois Specialty Clinic, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Deaconess Illinois Specialty Clinic, Inc. is (618) 242-0672.
- Who is the authorized official for Deaconess Illinois Specialty Clinic, Inc.?
- The authorized official listed on Deaconess Illinois Specialty Clinic, Inc.'s NPPES record is Kyle Dillman, Secretary Treasurer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Deaconess Illinois Specialty Clinic, Inc.'s NPI active?
- Yes — Deaconess Illinois Specialty Clinic, Inc.'s NPI (1003523374) is active in the NPPES registry as of the last update on 2023-01-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.