Cep America - Illinois Snf, Llp | |
601 W Lincoln Ave Caseyville IL 62232-1306 | |
(618) 345-3072 | |
Not Available |
Full Name | Cep America - Illinois Snf, Llp |
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Speciality | Internal Medicine |
Location | 601 W Lincoln Ave, Caseyville, Illinois |
Authorized Official Name and Position | Theophile G. Koury (ADMINISTRATIVE VICE PRESIDENT) |
Authorized Official Contact | 5103502600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cep America - Illinois Snf, Llp 2100 Powell St Ste 900 Emeryville CA 94608-1844 Ph: (510) 350-2600 | Cep America - Illinois Snf, Llp 601 W Lincoln Ave Caseyville IL 62232-1306 Ph: (618) 345-3072 |
NPI Number | 1215403241 |
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Provider Enumeration Date | 10/17/2018 |
Last Update Date | 10/17/2018 |
Identifier | Type | State | Issuer |
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1215403241 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |