Mission Care of Illinois LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1746251 Issued in IL

Legal business name

MISSION CARE OF ILLINOIS LLC

Doing business as

Abbott EMS

Practice address

4400 N Belt W
Belleville, IL 62226-5280

Phone

(618) 233-4820

Fax

(618) 233-4830

NPI assigned

Jan 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Scott Tierney

Title

Evp, Chief Financial Officer

Phone

(833) 703-2294

Specialties & licenses 2

Addresses

Other names 1

• Abbott EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mission Care of Illinois, LLC

  • Ambulance
  • Benton, IL
  • NPI 1548526932

  O20041207000484

  Same enrollment
• Mission Care of Illinois, LLC

  • Ambulance
  • Decatur, IL
  • NPI 1619499878

  O20041207000484

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mission Care of Illinois LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mission Care of Illinois, LLC

  • Ambulance
  • Benton, IL
  • NPI 1548526932
  NPD tax ID
• Mission Care of Illinois, LLC

  • Ambulance
  • Decatur, IL
  • NPI 1619499878
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1164572855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847199",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847199",
            "telephone_number": "800-913-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265280",
            "telephone_number": "618-233-4820",
            "fax_number": "618-233-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CARE OF ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "TIERNEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EVP, CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "833-703-2294"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "1746251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abbott EMS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Abbott EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ky A Miller, MSW, LSW, LCSW
• Kelly J Mincemeyer, OT
• Stephanie Miner
• Jennifer Nicole Mioux
• Harvey Lee Mirly, M.D.
• Christine Ellen Mitchell-Endsley
• Sheila Mitchell-Hawkins, PT
• Ashlie Kristina Mitchell, MS, CCC-SLP
• Catherine Ann Mitchell, PT
• Joann Dawn Mix, PT

• Land Ambulance in Belleville, IL
• Providers in Belleville, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.