Mission Care of Illinois, LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

MISSION CARE OF ILLINOIS, LLC

Doing business as

Abbott EMS

Practice address

417 W Wood St
Decatur, IL 62522-3109

Phone

(314) 768-1212

NPI assigned

Jul 10, 2017

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

  • Land Ambulance
  • Belleville, IL
  • NPI 1164572855

  O20041207000484

  Same enrollment
• Mission Care of Illinois, LLC

  • Ambulance
  • Benton, IL
  • NPI 1548526932

  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

  • Land Ambulance
  • Belleville, IL
  • NPI 1164572855
  NPD tax ID
• Mission Care of Illinois, LLC

  • Ambulance
  • Benton, IL
  • NPI 1548526932
  NPD tax ID

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1619499878",
    "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": "417 W WOOD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625223109",
            "telephone_number": "314-768-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION CARE OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "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"
        }
    ]
}

• Minds Matter Behavioral Health and Consultation Services LLC
• Stephen Miner, RBT
• Mohamad Minhem, M.D.
• Judy Ann Minton, CNP
• Michelle Elizabeth Minton, LCPC
• Cassie Mitchell, LSW
• Jignesh Modi, M.D.
• Laura Moma, MA, CCC-SLP
• Mamatha Moodalagiriaiah, M.D
• Karen Sue Moody, CRNA

• Ambulance in Decatur, IL
• Providers in Decatur, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.