Deaconess Illinois Clinic, Inc
NPI 1386361400ActiveOrganization· Family Medicine· Waterloo, IL
Family Medicine in Waterloo, Illinois, registered in NPPES in October 2022. The authorized official on file is Kyle Dillman, Secretary.
Overview
| NPI | 1386361400 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 20, 2022 |
| Last updated in NPPES | Jan 26, 2023 |
| Certified by provider | Jan 26, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Internal Medicine, Geriatric Medicine | 207RG0300X | — | — |
| Physician Assistant | 363A00000X | — | — |
| 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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