NPIMap

Organization Active NPI

Mental Health Centers of Central Illinois

Doing business as Memorial Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
National Provider Identifier
1225008113
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
Doing business as
Memorial Behavioral Health
Practice address
710 N 8TH St
Springfield, IL 62702
Phone
(217) 525-1064
Fax
(217) 525-1651
NPI assigned
Jan 24, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Ann Bowling
Title
Director
Phone
(217) 588-2626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

710 N 8TH St
Springfield, IL 62702

Mailing address

710 N 8TH St
Springfield, IL 62702-6324
Phone (217) 525-1064

Other names 1

  • Memorial Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040127000030 IL Part B Supplier - Clinic/Group Practice 8325940521 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
Practice locations: Springfield, IL; Jacksonville, IL
O20041222000489 IL Part B Supplier - Clinic/Group Practice 8325940521 Receives reassigned benefits from 18 practitioners
Practice locations: Springfield, IL; Lincoln, IL; Jacksonville, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

901 N 1st St
Ste 225
Springfield, IL 62702
Phone (217) 523-2217

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1225008113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026324",
            "telephone_number": "217-525-1064",
            "fax_number": "217-525-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-525-1064",
            "fax_number": "217-525-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-588-2626"
    },
    "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": "Memorial Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.