MEMORIAL MEDICAL CENTER (NPI# 1124446034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124446034 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER |
| Other Organization Name | MCHENRY COUNTY CRISIS PROGRAM |
| Practice Address |
3701 Doty Road Woodstock IL 60098 |
| Practice Telephone | 8153382910 |
| Practice Fax Number | 8153382912 |
| Mailing Telephone | 8153382910 |
| Mailing Fax Number | 8153382912 |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2016-04-01 |
| Authorized Official Name | DAVID TOMLINSON (CIO & CFO) |
| Authorized Official Telephone | 8157885831 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| McHenry County Crisis Program | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719836 | Memorial Medical Center | Nursing Care | 118 Trinity Shores Drive, Port Lavaca, TX 77979 | 2019-09-18 |
| 1497153589 | Memorial Medical Center | Family Medicine | 1016 N. Virginia St., Port Lavaca, TX 77979-0000 | 2014-12-05 |
| 1588075964 | Memorial Medical Center | Skilled Nursing Facility | 2100 Dove Crossing Ln, Navasota, TX 77868-5247 | 2014-05-19 |
| 1275717894 | Memorial Medical Center | Skilled Nursing Facility | 2750 Miller Ranch Rd, Pearland, TX 77584-9763 | 2007-12-18 |
| 1679549968 | Memorial Medical Center | Audiologist | 644 North Second Street, Springfield, IL 62781-0001 | 2006-02-27 |
| 1124099098 | Memorial Medical Center | General Acute Care Hospital | 701 N !st St, Mab 528, Springfield, IL 62781-0001 | 2006-01-30 |
| 1922092790 | Memorial Medical Center | Skilled Nursing Facility | 1008 Enterprise Blvd, Rockport, TX 78382-3201 | 2005-09-07 |
| 1568017481 | Memorial Medical Center | Clinic/Center | 701 N 1st St, Springfield, IL 62781-0001 | 2019-08-07 |
| 1053964742 | Memorial Medical Center | Orthopaedic Surgery | 815 N Virginia St, Port Lavaca, TX 77979-3025 | 2019-07-22 |
| 1164954806 | Memorial Medical Center | Internal Medicine | 701 N 1st St, Mailbox 95, Springfield, IL 62781-0001 | 2017-03-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER | 8260 Atlee Rd Ste 1203, Mechanicsville, VA 23116-1844 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER INC | 1615 Maple Ln, Ashland, WI 54806-3610 |
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER OF EAST TEXAS | 1201 W Frank Ave, Lufkin, TX 75904-3357 |
| Street Address |
3701 DOTY ROAD |
| City | WOODSTOCK |
| State | IL |
| Zip Code | 60098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730188194 | Woodstock Imaging Associates, Inc. | Radiology | 3701 Doty Road, Attn: Memorial Medical Center/radiology Dept., Woodstock, IL 60098 | 2005-07-19 |
| 1255689188 | Adeniyi C Ademoyo | Nurse Anesthetist, Certified Registered | 3701 Doty Road, Woodstock, IL 60098 | 2012-08-27 |
| 1982836789 | Tiffanie Ann Young | Dietitian, Registered | 3701 Doty Road, Centegra Hospital - Woodstock, Woodstock, IL 60098 | 2009-08-13 |
| 1508806449 | Yuliya Rukhlyada | Anesthesiology | 3701 Doty Road, Centegra Memorial Medical Center / Anesthesia Dept., Woodstock, IL 60098 | 2006-06-08 |
| 1295736080 | Donald R. Kennard | Radiology | 3701 Doty Road, Memorial Medical Center / Radiology Department, Woodstock, IL 60098 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197453 | Abb Dental Group LLC | Dentist | 11585 Us 14, Woodstock, IL 60098 | 2018-09-12 |
| 1396256467 | Gezelle Adams | Social Worker | 1200 Walden Oaks Dr, Woodstock, IL 60098 | 2017-10-17 |
| 1861910721 | Letitia Susan Edgell | Technician | 503 Lawndale Ave., Woodstock, IL 60098 | 2017-08-31 |
| 1104355460 | Jessica Evertsen | Doula | 435 Laurel Ave, Woodstock, IL 60098 | 2017-06-08 |
| 1871026724 | Bo Yeon Bartilotta | Dentist | 11585 Us-14, Woodstock, IL 60098 | 2017-04-07 |
| 1619337185 | Julia Karibian | Community Health Worker | 2983 Strauss Court, Woodstock, IL 60098 | 2016-02-26 |
| 1407249170 | Julia Bonti | Counselor | 13318 Hickory Ln, Woodstock, IL 60098 | 2015-03-05 |
| 1427485580 | Sara E Smedinghoff | Physical Therapy Assistant | 708 Washington Street, Woodstock, IL 60098 | 2013-10-03 |
| 1669721783 | Robert Eugene Haraden | Dentist | 651 S. Eastwood Dr, Woodstock, IL 60098 | 2012-09-05 |
| 1831447440 | Carla Peltier | Social Worker | 101 South Jefferson Street, Woodstock, IL 60098 | 2012-08-29 |
| Find all providers in zip 60098 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093338246 | Association for Individual Development | Clinic/Center | 1201 Dean St Lowr Level, Woodstock, IL 60098-3803 | 2020-05-22 |
| 1366906778 | Center for Authentic Life & Relationship, LLC | Clinic/Center | 1426 Olde Forge Ln, Woodstock, GA 30189-1553 | 2019-01-30 |
| 1508341413 | Resiliency Therapy Services | Clinic/Center | 213 Highland Park Pt, Woodstock, GA 30188-4897 | 2018-09-26 |
| 1952858557 | Tranquility Counseling Services | Clinic/Center | 8744 Main Street, 303, Woodstock, GA 30188 | 2016-09-01 |
| 1083861975 | The Thresholds | Clinic/Center | 3909 Raycraft Rd, Woodstock, IL 60098-8307 | 2008-08-21 |
| 1962036921 | Northern Illinois Medical Center | Clinic/Center | 3701 Doty Rd, Woodstock, IL 60098-7509 | 2020-02-28 |
| 1285278432 | Pioneer Center for Human Services | Clinic/Center | 13707 W Jackson St, Woodstock, IL 60098-3188 | 2019-10-31 |
| 1912551490 | Next Level Counseling and Wellness LLC | Clinic/Center | 226 W Judd St, Woodstock, IL 60098-3158 | 2019-08-01 |
| 1295215606 | Flow of Wellness LLC | Clinic/Center | 205 River Park North Dr, Woodstock, GA 30188-7835 | 2018-08-15 |
| 1952890105 | Rose Kihara Nurse Practitioner LLC | Clinic/Center | 39 Route 171, Woodstock, CT 06281 | 2018-05-03 |
| Find all providers in WOODSTOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.