Active NPI
Mission Care of Illinois, LLC
- Ambulance
- Benton, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- MISSION CARE OF ILLINOIS, LLC
- Doing business as
- Abbott EMS
- Practice address
- 137 Industrial Park Rd
Benton, IL 62812-4541 - Phone
- (314) 768-1212
- NPI assigned
- Apr 10, 2012
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Primary | ||
| Land Ambulance | 3416L0300X |
Addresses
Primary practice location
137 Industrial Park Rd
Benton, IL 62812-4541
Mailing address
PO Box 847199
Dallas, TX 75284-7199
Phone (800) 913-9106
Other names 1
- Abbott EMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041207000484 | IL | Part B Supplier - Ambulance Service Supplier | 3375509896 |
2 other NPIs on this enrollment Practice locations: Belleville, IL; Shelbyville, IL; Mattoon, IL; Benton, IL; Decatur, IL |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2037815 | Mission Care of Illinois, L L C | Certificate of waiver | Mar 6, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Mission Care of Illinois LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Land Ambulance
- Belleville, IL
- NPI 1164572855
-
- Ambulance
- Decatur, IL
- NPI 1619499878
Locations
25 Royal Heights Ctr
Belleville, IL 62226
Phone (618) 233-4820
4400 N Belt W
Unit B
Belleville, IL 62226
Phone (618) 233-4820
301 E Park St
Benton, IL 62812
Phone (618) 435-3103
137 Industrial Park Rd
Benton, IL 62812
Phone (314) 768-1212
1209 N Wenthe Dr
Ste C
Effingham, IL 62401
Phone (618) 219-5418
219 N Cedar St
Shelbyville, IL 62565
Phone (217) 765-0285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778630400000",
"number": "1548526932",
"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": "137 INDUSTRIAL PARK RD",
"city": "BENTON",
"state": "IL",
"postal_code": "628124541",
"telephone_number": "314-768-1212"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MISSION CARE OF ILLINOIS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-10",
"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": true
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Abbott EMS",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Abbott EMS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Benton, IL
Sources for this page
- 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.