Deaconess IL Clinic Eleven S – Family Medicine Physician, NPI 1962128256
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Deaconess IL Clinic Eleven S
PO BOX 34156
BELFAST, ME 049150619
Phone: (812) 450-6815
Fax: (812) 450-6822
Type: Mailing
1000 ELEVEN S STE 2E
COLUMBIA, IL 622361079
Phone: (618) 281-2773
Fax: (618) 281-0245
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-02-20
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04915)
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