Organization
VITUITY - ILLINOIS AUC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY MD (ADMINISTRATIVE VP OF OPERATIONS)
(510) 350-2600
Entity
Organization
Contact information
Practice address
12866 TROXLER AVE, HIGHLAND, IL 62249
(618) 651-2727
Mailing address
1601 CUMMINS DR STE D, MODESTO, CA 95358-6411
(510) 350-2680
(510) 879-9074
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
04/26/2018
Last updated
04/07/2020
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