Deaconess Illinois Clinic, Inc
NPI 1962128256ActiveOrganization· Family Medicine· Columbia, IL
Family Medicine in Columbia, Illinois, registered in NPPES in October 2022. The authorized official on file is Kyle Dillman, Secretary / Treasurer. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962128256 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 18, 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 | — | — |
| 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) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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