Memorial Medical Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MEMORIAL MEDICAL CENTER

Practice address

3701 Doty Road
Woodstock, IL 60098

Phone

(815) 338-2910

Fax

(815) 338-2912

NPI assigned

Mar 29, 2014

Last updated

Apr 1, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

MEMORIAL MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

David Tomlinson

Title

Cio & Cfo

Phone

(815) 788-5831

Specialties & licenses 1

Addresses

Other names 1

• McHenry County Crisis Program Other name

Part of

Memorial Medical Center

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1124446034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 DOTY ROAD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-2910",
            "fax_number": "815-338-2912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 DOTY ROAD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-2910",
            "fax_number": "815-338-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL MEDICAL CENTER",
        "enumeration_date": "2014-03-29",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "TOMLINSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CIO & CFO",
        "authorized_official_telephone_number": "815-788-5831"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McHenry County Crisis Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• McHenry County Youth Service Bureau
• Denise Arlen McNatt, PA-C
• Heidi Meador, PT
• Norman J Mecwan, PT
• Gabrielle Melchert
• Memorial Medical Center (Centegra Hospital Woodstock)
• Memorial Medical Center (Centegra Hospital Woodstock)
• Memorial Medical Center (Centegra Hospital Woodstock)
• Mercy Health System Corporation (Mercy Woodstock Pharmacy)
• Mercy Health System Corporation (Mercy Woodstock Medical Center)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.