Organization
CEP AMERICA ILLINOIS INTENSIVISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY M.D. (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 223-7750
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
08/24/2016
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