# MEMORIAL PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558614867
- **Authorized official:** JAMES T DOWELL (VICE PRESIDENT, MPS)
- **Authorized official phone:** (217) 788-3342

## Contact information

- **Practice address:** 15 FOUNDERS LN, SUITE 100, JACKSONVILLE, IL 62650-3919
- **Practice address phone:** (217) 243-0300
- **Practice address fax:** (217) 245-6775
- **Mailing address:** PO BOX 3428, SPRINGFIELD, IL 62708-3428
- **Mailing address phone:** (800) 577-5368
- **Mailing address fax:** (217) 757-2021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/24/2012
- **Last updated:** 02/11/2021