Cep America - Illinois Snf, LLP
Internal Medicine in Caseyville, IL. Organization (NPI-2).
NPI number1215403241
StatusActive
Last updated in NPPESOct 17, 2018
Details
- NPI
- 1215403241
- Entity type
- Organization (NPI-2)
- Legal business name
- Cep America - Illinois Snf, LLP
- Organization subpart
- No
- Enumeration date
- Oct 17, 2018
- Last updated
- Oct 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
601 W Lincoln AveCaseyville, IL 62232-1306
Phone 618-345-3072
Mailing address
2100 Powell St Ste 900Emeryville, CA 94608-1844
Phone 510-350-2600
Authorized official
Theophile G. Koury
Administrative Vice President
5103502600
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