Organization
MEMORIAL MEDICAL CENTER
Active
Organization
MEMORIAL MEDICAL CENTER
Active
Other names
Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BOWLING (DIRECTOR)
(217) 588-2626
Entity
Organization
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-5185
(217) 788-3000
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-7550
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
812400
MEDICARE GROUP NUMBER
IL
Enumeration date
04/03/2006
Last updated
01/30/2024
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