Organization
MEMORIAL HOSPITAL
Active
Other names
Randolph Hospital District
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MORGAN K BENDORF CPA (CFO)
(618) 826-4581
Entity
Organization
Contact information
Practice address
1900 STATE ST, CHESTER, IL 62233-1116
(618) 826-4581
(618) 826-4813
Mailing address
1900 STATE ST, CHESTER, IL 62233-1116
(618) 826-4581
(618) 826-4813
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036051292
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036052369
IL
207Q00000X
Family Medicine Physician
036-051292
IL
207Q00000X
Family Medicine Physician
036-052369
IL
207Q00000X
Family Medicine Physician
036-087561
IL
207Q00000X
Family Medicine Physician
036-130378
IL
207Q00000X
Family Medicine Physician
036-141161
IL
208600000X
Surgery Physician
036-046019
IL
208600000X
Surgery Physician
036-127160
IL
282NC0060X
Critical Access Hospital
Primary
0001495
IL
333600000X
Pharmacy
054017088
IL
363A00000X
Physician Assistant
085-003568
IL
363A00000X
Physician Assistant
085-003575
IL
367500000X
Certified Registered Nurse Anesthetist
041-149926
IL
367500000X
Certified Registered Nurse Anesthetist
209-009387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001495
IDPH
IL
Enumeration date
07/19/2005
Last updated
09/02/2022
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