Organization
CEP AMERICIA-ILLINOIS INTENSIVISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1404 CROSS ST, SHILOH, IL 62269-2988
(618) 233-7750
Mailing address
2100 POWELL ST STE 900, EMERYVILLE, CA 94608-1844
(510) 350-2680
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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