OrganizationActive
Memorial Physician Services
NPI 1104179415 · Rural Health Clinic/Center · Jacksonville, IL
Provider details
- NPI number
- 1104179415
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- James Dowell, Vice President, Mps(217) 788-3342
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1602 W Lafayette Ave
Jacksonville, IL 62650-1007
Phone: (217) 243-7200
Fax: (217) 243-6165
Street-level locationGet directions
Mailing address
Po Box 3428
Springfield, IL 62708-3428
Registry dates
- Enumerated
- 2012-10-24
- Last updated
- 2012-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.