Organization
MEMORIAL MEDICAL CENTER
Active
Other names
Centegra Hospital Woodstock
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TOMLINSON (CIO & CFO)
(815) 788-5831
Entity
Organization
Contact information
Practice address
3701 DOTY RD, WOODSTOCK, IL 60098-7509
(815) 338-2500
(815) 334-3948
Mailing address
527 W SOUTH ST, WOODSTOCK, IL 60098-3756
(815) 338-2500
(815) 334-3948
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
0001503
IL
282N00000X
General Acute Care Hospital
Primary
0004606
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1819
BLUECROSS SUBSTANCE ABUSE
IL
01
—
79
BLUE CROSS
IL
Enumeration date
07/31/2006
Last updated
03/21/2014
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