Deaconess Illinois Specialty Clinic, Inc.
NPI 1972210235 · Surgery Physician · Marion, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Deaconess Illinois Specialty Clinic, Inc. is a Surgery Physician organization in Marion, IL (NPI 1972210235).
Provider details
- NPI number
- 1972210235
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kyle Dillman, Secretary Treasurer(812) 450-7399
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Urology Physician208800000X
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
- Allergy & Immunology Physician207K00000X
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
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 3331 Deyoung
- Doing business as
- River to River Heart Group
- Doing business as
- Southern Illinois Vein Clinic
Registry dates
- Enumerated
- 2022-11-04
- Last updated
- 2026-05-23
- Certified
- 2026-05-23
Frequently asked questions
- What is Deaconess Illinois Specialty Clinic, Inc.'s NPI number?
- Deaconess Illinois Specialty Clinic, Inc.'s National Provider Identifier (NPI) is 1972210235, 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 Surgery 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 3331 W Deyoung St, Marion, IL 62959-5896.
- 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) 998-7155.
- Does Deaconess Illinois Specialty Clinic, Inc. accept Medicare?
- Deaconess Illinois Specialty 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 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 (1972210235) is active in the NPPES registry as of the last update on 2026-05-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.