Cep America - Illinois Snf, LLP

NPI #1104395441 in Cahokia, Illinois

Provider Information

NPI Number: 1104395441
Entity Type: Organization
Organization Name: Cep America - Illinois Snf, LLP
Primary Specialty: Internal Medicine
Enumeration Date: Nov 15, 2018
Last Updated: Mar 30, 2020

Practice Location

Address: 2 ANNABLE CT
City: Cahokia
State: Illinois
ZIP Code: 62206-2204
Phone: (618) 332-0114

Authorized Official

Name: THEOPHILE KOURY, M.D
Title: ADMINISTRATIVE VP OF OPERATIONS
Phone: (510) 350-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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