MEMORIAL MEDICAL CENTER (NPI# 1588673628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588673628 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER |
| Other Organization Name | CENTEGRA HOSPITAL WOODSTOCK |
| Practice Address |
527 W South St Woodstock IL 60098-3756 |
| Practice Telephone | 8153382500 |
| Practice Fax Number | 8153343948 |
| Mailing Telephone | 8153382500 |
| Mailing Fax Number | 8153343948 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2014-03-21 |
| Authorized Official Name | DAVID TOMLINSON (CIO & CFO) |
| Authorized Official Telephone | 8157885831 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0001503 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 1159 | 01 |
| Other Name | Type Code |
|---|---|
| Centegra Hospital Woodstock | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719836 | Memorial Medical Center | Nursing Care | 118 Trinity Shores Drive, Port Lavaca, TX 77979 | 2019-09-18 |
| 1497153589 | Memorial Medical Center | Family Medicine | 1016 N. Virginia St., Port Lavaca, TX 77979-0000 | 2014-12-05 |
| 1588075964 | Memorial Medical Center | Skilled Nursing Facility | 2100 Dove Crossing Ln, Navasota, TX 77868-5247 | 2014-05-19 |
| 1275717894 | Memorial Medical Center | Skilled Nursing Facility | 2750 Miller Ranch Rd, Pearland, TX 77584-9763 | 2007-12-18 |
| 1679549968 | Memorial Medical Center | Audiologist | 644 North Second Street, Springfield, IL 62781-0001 | 2006-02-27 |
| 1124099098 | Memorial Medical Center | General Acute Care Hospital | 701 N !st St, Mab 528, Springfield, IL 62781-0001 | 2006-01-30 |
| 1922092790 | Memorial Medical Center | Skilled Nursing Facility | 1008 Enterprise Blvd, Rockport, TX 78382-3201 | 2005-09-07 |
| 1568017481 | Memorial Medical Center | Clinic/Center | 701 N 1st St, Springfield, IL 62781-0001 | 2019-08-07 |
| 1053964742 | Memorial Medical Center | Orthopaedic Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2019-07-22 |
| 1164954806 | Memorial Medical Center | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER | 8260 Atlee Rd Ste 1203, Mechanicsville, VA 23116-1844 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER INC | 1615 Maple Ln, Ashland, WI 54806-3610 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER OF EAST TEXAS | 1201 W Frank Ave, Lufkin, TX 75904-3357 |
| Street Address |
527 W SOUTH ST |
| City | WOODSTOCK |
| State | IL |
| Zip Code | 60098-3756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992704225 | Roger C Gronau | Psychologist | 527 W South St, Woodstock, IL 60098-3756 | 2005-07-19 |
| 1750753265 | Taylor Moore | Social Worker | 527 W South St, Woodstock, IL 60098-3756 | 2015-10-22 |
| 1487022042 | Mandy Cwick | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2015-09-11 |
| 1902220312 | Nicole Davidson | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-02-06 |
| 1710301221 | David Washington | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-02-05 |
| 1750704417 | Patricia Mason | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-01-30 |
| 1033532809 | Diana French | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-01-29 |
| 1427471341 | Amanda Hinthorne | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-01-28 |
| 1669895777 | John Druszczak | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-01-24 |
| 1851714083 | Adrienne J Liebich | Counselor | 527 W South St, Woodstock, IL 60098-3756 | 2014-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197453 | Abb Dental Group LLC | Dentist | 11585 Us 14, Woodstock, IL 60098 | 2018-09-12 |
| 1396256467 | Gezelle Adams | Social Worker | 1200 Walden Oaks Dr, Woodstock, IL 60098 | 2017-10-17 |
| 1861910721 | Letitia Susan Edgell | Technician | 503 Lawndale Ave., Woodstock, IL 60098 | 2017-08-31 |
| 1104355460 | Jessica Evertsen | Doula | 435 Laurel Ave, Woodstock, IL 60098 | 2017-06-08 |
| 1871026724 | Bo Yeon Bartilotta | Dentist | 11585 Us-14, Woodstock, IL 60098 | 2017-04-07 |
| 1619337185 | Julia Karibian | Community Health Worker | 2983 Strauss Court, Woodstock, IL 60098 | 2016-02-26 |
| 1407249170 | Julia Bonti | Counselor | 13318 Hickory Ln, Woodstock, IL 60098 | 2015-03-05 |
| 1427485580 | Sara E Smedinghoff | Physical Therapy Assistant | 708 Washington Street, Woodstock, IL 60098 | 2013-10-03 |
| 1669721783 | Robert Eugene Haraden | Dentist | 651 S. Eastwood Dr, Woodstock, IL 60098 | 2012-09-05 |
| 1831447440 | Carla Peltier | Social Worker | 101 South Jefferson Street, Woodstock, IL 60098 | 2012-08-29 |
| Find all providers in zip 60098 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225256696 | Woodstock Christian Life Services | Skilled Nursing Facility | 920 N Seminary Ave, Woodstock, IL 60098-2996 | 2007-04-23 |
| 1164405106 | Wrhc & Rc Inc. | Skilled Nursing Facility | 309 Mchenry Ave, Woodstock, IL 60098 | 2005-11-23 |
| 1891795837 | County of Mchenry Illinois | Skilled Nursing Facility | 2406 Hartland Rd, Woodstock, IL 60098-9763 | 2005-07-29 |
| 1588660682 | Chc -woodstock Nursing & Rehab Center, LLC | Skilled Nursing Facility | 105 Arnold Mill Rd, Woodstock, GA 30188-5027 | 2005-06-23 |
| 1558839167 | Als Woodstock Inc | Skilled Nursing Facility | 1649 Park Rd, Woodstock, OH 43084-9713 | 2018-11-13 |
| 1073020236 | Spring Meadow Healthcare LLC | Skilled Nursing Facility | 1649 Park Rd, Woodstock, OH 43084-9713 | 2018-01-09 |
| 1942621917 | Woodstock Cypress LLC | Skilled Nursing Facility | 105 Arnold Mill Rd, Woodstock, GA 30188-5027 | 2013-12-18 |
| 1770884942 | Woodstock Healthcare Group, Inc. | Skilled Nursing Facility | 1649 Park Rd, Woodstock, OH 43084-9713 | 2010-11-04 |
| 1679715353 | Crossroads Care Center of Woodstock, LLC | Skilled Nursing Facility | 309 Mchenry Ave, Woodstock, IL 60098-2917 | 2009-03-27 |
| 1942214176 | Woodstock Facility Operations, LLC | Skilled Nursing Facility | 803 S Main St, Woodstock, VA 22664-1125 | 2006-07-27 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.