Organization
MEMORIAL MEDICAL CENTER
Active
Other names
Clinical Psychologists
Organization subpart
No
Provider details
NPI number
Authorized official
JAMESON M ROSZHART (PRESIDENT AND CEO)
(217) 788-3000
Entity
Organization
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Mailing address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
04/05/2006
Last updated
06/14/2024
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