Organization
CEP AMERICA - ILLINOIS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY M.D (VICE PRESIDENT OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
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
06/10/2015
Last updated
04/07/2020
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