Organization · NPI-2

Memorial Medical Center (Siu)

Psychiatric Unit · Springfield, IL

NPI number1548540982
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1548540982
Entity type
Organization (NPI-2)
Legal business name
Memorial Medical Center (Siu)
Organization subpart
No
Enumeration date
Aug 17, 2011
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
273R00000X Psychiatric Unit–ILYes

Practice location

701 N 1st St
Springfield, IL 62702-3757

Phone 217-545-4735

Mailing address

701 N 1st St.
Springfield, IL 62794-9636

Authorized official

Tesfaye Telila
Resident.
2175450182

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