Cep America - Illinois SNF, LLP
Organization Active NPI Internal Medicine Physician · Caseyville, IL
NPI 1215403241 · NPPES record last updated Oct 17, 2018
Key facts
- NPI
- 1215403241
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CEP AMERICA - ILLINOIS SNF, LLP
- Practice address
- 601 W Lincoln Ave
Caseyville, IL 62232-1306 - Phone
- (618) 345-3072
- NPI assigned
- Oct 17, 2018
- Organization subpart
- No
Authorized official
- Name
- Theophile G. Koury
- Title
- Administrative Vice President
- Phone
- (510) 350-2600
Other NPIs on the same Medicare enrollment 17
Corporate family (same tax ID) 9
Practitioners 6
-
Hana Filipova, M.D.
-
Khaled Jumean, M.D.
-
Anum Amir Niazi, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161012002933 | IL | Part B Supplier - Clinic/Group Practice | 8022306737 |
Receives reassigned benefits from 53 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Cahokia, IL; Shiloh, IL; Godfrey, IL; Edwardsville, IL; Caseyville, IL; Breese, IL; Belleville, IL; Alton, IL |
National Provider Directory
- Tax ID family
- Cep America - Illinois SNF LLP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
601 W Lincoln Ave
Caseyville, IL 62232-1306
Mailing address
2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2600
Other providers in Caseyville, IL
- A to Z Pediatrics, LLP
- Caseyville Nursing & Rehabilitation Center Inc.
- Caseyville Nursing & Rehabilitation Center Inc.
- Caseyville Rehabilitation and Nursing LLC
- Kimberly Paige Cinelli-Hampton
- Lori Lee Eberhart
- James V Eisele
- Eisele'S Caseyville Pharm
- Family Renewed, LLC
All providers in Caseyville, IL · Internal 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 Oct 17, 2018. 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.