Organization
CEP AMERICA ILLINOIS INTENSIVISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BIRDSALL MD (ADMINISTRATION VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-2000
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2680
(510) 879-9074
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
08/01/2018
Last updated
03/30/2020
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