Deaconess Illinois Specialty Clinic, Inc.
NPI 1386351849ActiveOrganization· Internal Medicine, Interventional Cardiology· Saint Louis, MO
Internal Medicine, Interventional Cardiology in Saint Louis, Missouri, registered in NPPES in November 2022. The authorized official on file is Kyle Dillman, Secretary Treasurer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1386351849 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 3, 2022 |
| Last updated in NPPES | Jan 26, 2023 |
| Certified by provider | Jan 26, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Interventional Cardiology Primary | 207RI0011X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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