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Contact Information

JEFFERY S DEACON, DPM
3403 PROFESSIONAL PARK DR
MARION, IL62959-6394
 Phone: 618-993-0333
 Fax: 618-993-0545
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFERY S DEACON · (Male)

NPI # 1104919075
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/02/2006
Last updated 04/16/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 016004769
  • IL Medicaid 016004769001
Hospital affiliation(s)
  • HEARTLAND REGIONAL MEDICAL CENTER - (Acute Care)
    3333 W DE YOUNG
    MARION, IL 62959
  • MEMORIAL HOSPITAL OF CARBONDALE - (Acute Care)
    405 W JACKSON
    CARBONDALE, IL 62902
  • UNION COUNTY HOSPITAL - (Critical Access)
    517 NORTH MAIN STREET
    ANNA, IL 62906
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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