# DEACONESS ILLINOIS RED BUD REGIONAL HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Red Bud Health Clinic, Deaconess Illinois Rural Health Clinic Red Bud
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619693926
- **Authorized official:** AMBER LIPE (CFO)
- **Authorized official phone:** (618) 998-7020

## Contact information

- **Practice address:** 325 SPRING ST, RED BUD, IL 62278-1105
- **Practice address phone:** (618) 282-7373
- **Practice address fax:** (618) 282-7376
- **Mailing address:** PO BOX 34143, BELFAST, ME 04915-0619
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (815) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/18/2022
- **Last updated:** 01/05/2024