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Organization

MEMORIAL MEDICAL CENTER (SIU)

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TESFAYE TELILA M.D (RESIDENT.)
(217) 545-0182
Entity
Organization

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62702-3757
(217) 545-4735
Mailing address
701 N 1ST ST., SPRINGFIELD, IL 62794-9636

Taxonomy

Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
IL

Other

Enumeration date
08/17/2011
Last updated
07/21/2022
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