Organization
MEMORIAL PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES T DOWELL (VICE PRESIDENT, MPS)
(217) 788-3342
Entity
Organization
Contact information
Practice address
3132 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7400
(217) 862-0800
(217) 862-0871
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/01/2012
Last updated
06/11/2020
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