institution
Memorial Physician Services
Rural Health Clinic/Center in Jacksonville, Illinois
NPI 1104179415

Memorial Physician Services is a Rural Health Clinic/Center based in Springfield, IL and is specialized in Rural Health. Memorial Physician Services practices in Jacksonville, IL. The NPI Number for Memorial Physician Services is 1104179415 and holds a License No. (Illinois).

The current practice location address for Memorial Physician Services is 1602 W Lafayette Ave, Jacksonville, IL and can be reached out via phone at 217-243-7200 and via fax at 217-243-6165.

Location: 1602 W Lafayette Ave, Jacksonville, IL, 62708-3428
institution
Provider Profile Details
NPI Number
1104179415
Provider Name
Memorial Physician Services
Credential
Provider Entity Type
Organization
Address
1602 W Lafayette Ave, Jacksonville, IL, 62708-3428
Phone Number
217-243-7200
Fax Number
217-243-6165
Provider Enumeration Date
10/24/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
148906 01 RHC MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1602 W Lafayette Ave
City
State
Zip
62650-1007
Phone Number
217-243-7200
Fax Number
217-243-6165
person
Provider Business Mailing Address Details
Address
1602 W Lafayette Ave
City
State
Zip
62650-1007
Phone Number
217-243-7200
Fax Number
217-243-6165
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rural Health
Taxonomy
License No.
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Definition
Definition to come...
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