Cep America Illinois LLP
Organization Active NPI Emergency Medicine Physician · Shiloh, IL
NPI 1134587637 · NPPES record last updated Jan 29, 2016
Key facts
- NPI
- 1134587637
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- CEP AMERICA ILLINOIS LLP
- Practice address
- 1404 Cross St
Shiloh, IL 62269-2988 - Phone
- (618) 233-7750
- NPI assigned
- Jan 29, 2016
- Organization subpart
- No
Authorized official
- Name
- Theophile Koury, MD
- Title
- Administrative VP of Operations
- Phone
- (510) 350-2680
Other NPIs on the same Medicare enrollment 35
Practitioners 14
-
Stephanie A Eugene, M.D.
-
Christopher Frantz, M.D.
-
Angela Kage, NP
-
Ashleigh Jordan Kennedy, M.D.
-
Michael Rafati, MD
-
Scott R. Samlan, M.D.
-
Leo W Sullivan. II, M.D.
-
Kendra Zerrusen, APN, FNP-BC
-
Richard K Baker, DNP, NP-C
-
Mary Margaret Brown, FNP
-
Michael Jin Kim, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120322000587 | IL | Part B Supplier - Clinic/Group Practice | 3274793633 |
Receives reassigned benefits from 1,241 practitioners 35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Elk Grove Village, IL; Evanston, IL; Greenville, IL; Highland, IL; Hoffman Estates, IL; Joliet, IL; Kankakee, IL; Libertyville, IL… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
1404 Cross St
Shiloh, IL 62269-2988
Mailing address
2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2680
Other providers in Shiloh, IL
- Antinia Cage
- Kaitlin McClenahan Campbell
- Chazz N Carr
- Cep America - Illinois SNF, LLP
- Cep America - Illinois SNF, LLP
- Cep America-Illinois Hospitalists, LLP
- Cep Americia-Illinois Intensivists
- Randi Christ
- James C Clanahan
- Clarkson Optometry Illinois PC
All providers in Shiloh, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.