Organization
CEP AMERICA ILLINOIS INTENSIVISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 851-7501
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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