Organization
CEPAMERICA ILLINOIS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2680
Entity
Organization
Contact information
Practice address
500 W COURT ST, KANKAKEE, IL 60901-3661
(815) 937-2400
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
08/10/2017
Last updated
04/07/2020
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