OrganizationActive
Memorial Medical Group, LLC
NPI 1235474057 · Internal Medicine Physician · Belleville, IL
Provider details
- NPI number
- 1235474057
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- James Davis, Executive Director(618) 257-6302
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pain Medicine (Anesthesiology) Physician207LP2900X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Gastroenterology Physician207RG0100X
Allopathic & Osteopathic Physicians
Practice location
4550 Memorial Dr
Ste. 340
Belleville, IL 62226-5372
Phone: (618) 257-6302
Fax: (618) 257-4838
Approximate (ZIP-level) locationGet directions
Mailing address
4550 Memorial Dr
Belleville, IL 62226-5372
Registry dates
- Enumerated
- 2012-12-05
- Last updated
- 2012-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.