Organization
CEP AMERICA - ILLINOIS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY MD (ADMINISTRATIVE VPO)
(510) 350-2644
Entity
Organization
Contact information
Practice address
2320 ROYAL BLVD, SUITE C, ELGIN, IL 60123-4717
(224) 783-5611
Mailing address
2100 POWELL ST STE 900, EMERYVILLE, CA 94608-1844
(510) 350-2644
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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