Kelly Lynn Dill, MA, CAGS, NCC

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

409 E Park St
Benton, IL 62812-1920

Phone

(618) 439-7231

NPI assigned

Jul 31, 2020

Last updated

Jul 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Franklin Jefferson Co SP Ed

  • Local Education Agency (LEA)
  • Benton, IL
  • NPI 1609901784
  NPD (past)

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1922618362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628125027",
            "telephone_number": "618-439-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E PARK ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121920",
            "telephone_number": "618-439-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILL",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA, CAGS, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE EDUCATOR LICENSE ID",
            "identifier": "1816584",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn a Jackson-Breeden DMD LTD
• Deaconess Illinois Clinic, Inc (Deaconess IL Clinic Bailey Ln)
• Deaconess Illinois Specialty Clinic, Inc. (Deaconess Illinois Clinic GI and Family Medicine)
• Deaconess Illinois Specialty Clinic, Inc. (Deaconess IL Specialty Bailey Ln)
• Kevin B Delatour, DMD
• Paula Dodge
• Rhonda Dunbar
• Macyn Dalainey Dunk, MS, CCC-SLP
• Samantha Durietz
• Pamela Kay Edmonds, RN

• Psychologist in Benton, IL
• Providers in Benton, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.