Cep America - Illinois Snf, LLP

NPI #1215403241 in Caseyville, Illinois

Provider Information

NPI Number: 1215403241
Entity Type: Organization
Organization Name: Cep America - Illinois Snf, LLP
Primary Specialty: Internal Medicine
Enumeration Date: Oct 17, 2018
Last Updated: Oct 17, 2018

Practice Location

Address: 601 W LINCOLN AVE
City: Caseyville
State: Illinois
ZIP Code: 62232-1306
Phone: (618) 345-3072

Authorized Official

Name: THEOPHILE G. KOURY
Title: ADMINISTRATIVE VICE PRESIDENT
Phone: (510) 350-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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