Organization
CEP AMERICA - ILLINOIS SNF, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE G. KOURY (ADMINISTRATIVE VICE PRESIDENT)
(510) 350-2600
Entity
Organization
Contact information
Practice address
601 W LINCOLN AVE, CASEYVILLE, IL 62232-1306
(618) 345-3072
Mailing address
2100 POWELL ST STE 900, EMERYVILLE, CA 94608-1844
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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