Memorial Physician Services

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MEMORIAL PHYSICIAN SERVICES

Practice address

1602 W Lafayette Ave
Jacksonville, IL 62650-1007

Phone

(217) 243-7200

Fax

(217) 243-6165

NPI assigned

Oct 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James T Dowell

Title

Vice President, MPS

Phone

(217) 788-3342

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Camilleri, DO

  • Internal Medicine Physician
  • Burr Ridge, IL
  • NPI 1295710044
  NPD (past)
• Kathleen A Sigle, CFNP

  • Family Nurse Practitioner
  • Chatham, IL
  • NPI 1316912561
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1104179415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501007",
            "telephone_number": "217-243-7200",
            "fax_number": "217-243-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "DOWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT, MPS",
        "authorized_official_telephone_number": "217-788-3342"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC MEDICARE PTAN",
            "identifier": "148906",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danica B McKain, APN
• Doug R McKain, DNP, FNP-C
• Allison Marie Meisner, M.D.
• Memorial Home Services of Central Illinois, Inc
• Memorial Industrial Rehabilitation of Jacksonville
• Memorial Physician Services
• Memorial Physician Services
• Memorial Physician Services
• Memorial Physician Services
• Mental Health Centers of Central Illinois

• All providers in Jacksonville, IL
• Rural Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.