# HEALTHCARE NETWORK ASSOCIATES OF SANGAMON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Memorial Express Care at Koke Mill
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588675482
- **Authorized official:** WILLIAM T KENDRICK JR. (DIRECTOR)
- **Authorized official phone:** (217) 757-7493

## Contact information

- **Practice address:** 3132 OLD JACKSONVILLE RD, SUITE 110, SPRINGFIELD, IL 62704-7400
- **Practice address phone:** (217) 862-0062
- **Practice address fax:** (217) 862-0064
- **Mailing address:** PO BOX 3428, SPRINGFIELD, IL 62708-3428
- **Mailing address phone:** (217) 757-7491
- **Mailing address fax:** (217) 757-2021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 06/16/2008