MEMORIAL PHYSICIAN SERVICES (NPI# 1790038099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790038099 |
Entity Type | Organization |
Organization Name | MEMORIAL PHYSICIAN SERVICES |
Practice Address |
1 Centre Dr Petersburg IL 62675-9467 |
Mailing Address |
Po Box 3428 Springfield IL 62708-3428 |
Practice Telephone | 2176327761 |
Practice Fax Number | 2176320312 |
Mailing Telephone | 8005775368 |
Mailing Fax Number | 2177572021 |
Enumeration Date | 2012-10-24 |
Last Update Date | 2012-10-26 |
Authorized Official Name | JAMES T DOWELL (VICE PRESIDENT, MPS) |
Authorized Official Telephone | 2177883342 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
RHC MEDICARE PTAN | 143936 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316470651 | Memorial Physician Services | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-04-04 |
1275065906 | Memorial Physician Services | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
1063961936 | Memorial Physician Services | General Acute Care Hospital | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2016-10-03 |
1205180056 | Memorial Physician Services | Clinic/Center | 1600 W Walnut St, East Wing, 3rd Floor, Jacksonville, IL 62650-1136 | 2012-11-01 |
1174877930 | Memorial Physician Services | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2012-11-01 |
1104179415 | Memorial Physician Services | Clinic/Center | 1602 W Lafayette Ave, Jacksonville, IL 62650-1007 | 2012-10-24 |
1558614867 | Memorial Physician Services | Clinic/Center | 15 Founders Ln, Suite 100, Jacksonville, IL 62650-3919 | 2012-10-24 |
1881947174 | Memorial Physician Services | Clinic/Center | 1606 W Lafayette Ave, Jacksonville, IL 62650-3707 | 2012-10-24 |
1568715126 | Memorial Physician Services | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2012-10-19 |
1477614105 | Memorial Physician Services | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2006-12-13 |
Street Address |
1 CENTRE DR |
City | PETERSBURG |
State | IL |
Zip Code | 62675-9467 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760457261 | Amanda L. Meeks | Family Medicine | 1 Centre Dr, Petersburg, IL 62675-9584 | 2006-02-20 |
1639426166 | Linda K Thornberry | Social Worker | 1 Centre Dr, Petersburg, IL 62675-9467 | 2012-08-15 |
1588815096 | Menard Medical Center, LLC | Clinic/Center | 1 Centre Dr, Petersburg, IL 62675-9467 | 2008-10-02 |
1437300043 | Menard Medical Center, LLC | Nurse Practitioner | 1 Centre Dr, Petersburg, IL 62675-9467 | 2008-10-02 |
1023230968 | Joe A Bilyeu | Family Medicine | 1 Centre Dr, Petersburg, IL 62675-9467 | 2007-05-02 |
1437278132 | Heather Walker | Occupational Therapist | 1 Centre Dr, Petersburg, IL 62675-9467 | 2007-03-27 |
1619091477 | Thelma Hinton | Physical Therapist | 1 Centre Dr, Petersburg, IL 62675-9467 | 2007-03-19 |
1740311349 | Maxoiim Tellez | Family Medicine | 1 Centre Dr, Petersburg, IL 62675-9467 | 2007-03-08 |
1235291220 | Healthcare Network Associates | Clinic/Center | 1 Centre Dr, Petersburg, IL 62675-9467 | 2006-12-15 |
1538259403 | Petersburg Pharmacy, Inc | Pharmacy | 1 Centre Dr, Suite 100, Petersburg, IL 62675-9467 | 2006-10-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962519405 | Porta Comm. Unit District 202 | Local Education Agency (LEA) | 17651 Bluejay Road, Petersburg, IL 62675 | 2006-08-23 |
1295704021 | Menard County Health Department | Home Health | 1120 N 4th, Suite A, Petersburg, IL 62675 | 2006-03-15 |
1720035611 | Menard Convalescent Center, Inc | Skilled Nursing Facility | 120 W Antle St, Petersburg, IL 62675-1035 | 2006-05-27 |
1003068776 | Menard Convalescent Center, Inc | Skilled Nursing Facility | 120 W Antle St, Petersburg, IL 62675-1035 | 2008-10-14 |
1528106812 | County of Menard | Public Health or Welfare | 1120 N 4th St, Suite A, Petersburg, IL 62675-1115 | 2007-02-01 |
1922478916 | Ashleigh Renee Smith | Private Vehicle | 703 N 7th St, Petersburg, IL 62675-1144 | 2015-10-02 |
1952872269 | Abbey Lynn Venturini | Social Worker | 323 W Rutledge St, Petersburg, IL 62675-1239 | 2018-12-12 |
1285936872 | Donald P. Hartman | Dentist | 213 N 5th, Petersburg, IL 62675-1303 | 2010-12-02 |
1114197514 | Paul Douglas Davis | Dentist | 213 N 5th St, Petersburg, IL 62675-1303 | 2008-03-03 |
1619091238 | Donald Paul Hartman | Dentist | 213 N 5th St, Petersburg, IL 62675-1303 | 2007-03-19 |
Find all providers in zip 62675 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689770083 | Little Company of Mary Hospital of Indiana, Inc | Clinic/Center | 1003 E Illinois St, Petersburg, IN 47567 | 2006-09-15 |
1588815096 | Menard Medical Center, LLC | Clinic/Center | 1 Centre Dr, Petersburg, IL 62675-9467 | 2008-10-02 |
1144388505 | Daviess County Hospital | Clinic/Center | 611 E Main St, Petersburg, IN 47567-1247 | 2006-12-05 |
1710098405 | Deaconess Hospital, Inc | Clinic/Center | 106 W Pike Ave, Petersburg, IN 47567-8750 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
1578040275 | Osf Healthcare System | Clinic/Center | 230 S Exchange St, Galva, IL 61434-1871 | 2018-07-25 |
1700380219 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1510 W Springfield Rd Ste A, Taylorville, IL 62568-2764 | 2018-03-20 |
1326542903 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1001 Avenue of Mid America Ste 4, Effingham, IL 62401-4634 | 2018-03-20 |
1649795659 | Harrisburg Medical Center Inc | Clinic/Center | 3106 Outer Dr Ste 200, Marion, IL 62959-5270 | 2017-08-10 |
1588186308 | Wabash General Hospital District | Clinic/Center | 1430 College Dr Ste A, Mount Carmel, IL 62863-2649 | 2017-07-13 |
Find all providers with the same taxonomy |
City | PETERSBURG |
Zip Code | 62675 |
Please comment or provide details below to improve the information on MEMORIAL PHYSICIAN SERVICES.
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.