Organization
CEP AMERICA - ILLINOIS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEOPHILE KOURY M.D. (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
77 N AIRLITE ST, ELGIN, IL 60123-4912
(847) 695-3200
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 851-7411
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
08/24/2016
Last updated
04/01/2020
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