Cep America - Illinois Snf, LLP
Internal Medicine in Godfrey, IL. Organization (NPI-2).
NPI number1891322467
StatusActive
Last updated in NPPESMar 24, 2020
Details
- NPI
- 1891322467
- Entity type
- Organization (NPI-2)
- Legal business name
- Cep America - Illinois Snf, LLP
- Organization subpart
- No
- Enumeration date
- Mar 24, 2020
- Certification date
- Mar 24, 2020
- Last updated
- Mar 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
1623 W Delmar AveGodfrey, IL 62035-1317
Phone 618-498-7157
Mailing address
1601 Cummins Dr Ste DModesto, CA 95358-6411
Phone 510-350-2638
Authorized official
David Birdsall
Administrative Vp Of Operations
6184987157
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