Cep America - Illinois SNF, LLP
Organization Active NPI Infectious Disease Physician · Granite City, IL
NPI 1831601376 · NPPES record last updated Oct 24, 2017
Key facts
- NPI
- 1831601376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- Legal business name
- CEP AMERICA - ILLINOIS SNF, LLP
- Practice address
- 2100 Madison Ave
Granite City, IL 62040-4713 - Phone
- (618) 798-3128
- NPI assigned
- Oct 24, 2017
- Organization subpart
- No
Authorized official
- Name
- David Birdsall, MD
- Title
- Administrative VP of Operations
- Phone
- (510) 350-2680
Other NPIs on the same Medicare enrollment 17
Practitioners 1
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | Yes |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040-4713
Mailing address
2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2680
Other providers in Granite City, IL
- Nicole Cain
- Kegan Calkins
- Anne Marie Calvert
- Jaime Ann Campbell
- Catholic Charities, Diocese of Springfield in Illinois
- Joshua Chambliss
- Randy Chapman
- Chen & Associates LTD
- William H Chen
- Chesntut Health Systems, Inc.
All providers in Granite City, IL · Infectious Disease 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 24, 2017. 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.