| Cep America - Illinois Snf, Llp | |
|
6800 State Route 162 Maryville IL 62062-8500 | |
| (618) 288-5711 | |
| Not Available |
| Full Name | Cep America - Illinois Snf, Llp |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 6800 State Route 162, Maryville, Illinois |
| Authorized Official Name and Position | David Birdsall (ADMINISTRATIVE VP OF OPERATIONS) |
| Authorized Official Contact | 5103502680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cep America - Illinois Snf, Llp 2100 Powell St Emeryville CA 94608-1826 Ph: (510) 350-2680 | Cep America - Illinois Snf, Llp 6800 State Route 162 Maryville IL 62062-8500 Ph: (618) 288-5711 |
| NPI Number | 1386156826 |
|---|---|
| Provider Enumeration Date | 10/24/2017 |
| Last Update Date | 10/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386156826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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Innovative Women's Healthcare, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2016 Vadalabene Dr Ste D, Maryville, IL 62062 Phone: 618-444-5475 | |
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Mark Fedder, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6810 State Route 162, Suite 211, Maryville, IL 62062 Phone: 618-288-0346 Fax: 618-288-0349 |