OrganizationActive
Deaconess Illinois Specialty Clinic, Inc.
NPI 1154036259 · Nurse Practitioner · Marion, IL
Provider details
- NPI number
- 1154036259
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kyle Dillman, Secretary(812) 450-7399
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(59/100 index)
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
3331 W Deyoung St Ste 101
Marion, IL 62959-5896
Phone: (618) 998-7169
Fax: (618) 998-7533
Street-level locationGet directions
Mailing address
3331 W Deyoung St Ste 101
Marion, IL 62959-5896
Other names (DBA / former)
- Doing business as
- Deaconess Il Specialty Clinic Occupational Health
- Doing business as
- Deaconess Il Specialty Clinic Occupational Health
Registry dates
- Enumerated
- 2023-01-23
- Last updated
- 2023-01-26
- Certified
- 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.