Organization
CEPAMERICA ILLINOIS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY MD (VPO)
(510) 350-2600
Entity
Organization
Contact information
Practice address
3249 S. OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-9100
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
10/24/2011
Last updated
04/07/2020
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