Deaconess Illinois Clinic, Inc
NPI 1962128256 · Family Medicine Physician · Columbia, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Deaconess Illinois Clinic, Inc is a Family Medicine Physician organization in Columbia, IL (NPI 1962128256).
Provider details
- NPI number
- 1962128256
- 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
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing 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 Clinic Eleven S
- Doing business as
- Family Practice Associates
Registry dates
- Enumerated
- 2022-10-18
- Last updated
- 2023-01-26
- Certified
- 2023-01-26
Frequently asked questions
- What is Deaconess Illinois Clinic, Inc's NPI number?
- Deaconess Illinois Clinic, Inc's National Provider Identifier (NPI) is 1962128256, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Deaconess Illinois Clinic, Inc?
- Deaconess Illinois Clinic, Inc is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Deaconess Illinois Clinic, Inc located?
- Deaconess Illinois Clinic, Inc's practice location on file with NPPES is 1000 Eleven S Ste 2e, Columbia, IL 62236-1079.
- What is Deaconess Illinois Clinic, Inc's phone number?
- The practice phone number listed in the NPPES registry for Deaconess Illinois Clinic, Inc is (618) 281-2773.
- Does Deaconess Illinois Clinic, Inc accept Medicare?
- Deaconess Illinois Clinic, Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Deaconess Illinois Clinic, Inc?
- The authorized official listed on Deaconess Illinois 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 Clinic, Inc's NPI active?
- Yes — Deaconess Illinois Clinic, Inc's NPI (1962128256) 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.