Cep America -Illinois PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CEP AMERICA -ILLINOIS PC

Practice address

2112 S Michigan Ave
Chicago, IL 60616-1704

Phone

(630) 372-1100

NPI assigned

Jul 30, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Theophile Koury, MDNPI 1568483691

Title

Admin Vice President of Ops

Phone

(510) 350-2842

Specialties & licenses 4

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theophile G. Koury, M.D.

  • Emergency Medicine Physician
  • Walnut Creek, CA
  • NPI 1568483691
  NPD (past) Authorized official
• Lindsey Marie Soderlund, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1750808127
  NPD
• Mark Jeffrey Spiro, M.D.

  • Emergency Medicine Physician
  • Escondido, CA
  • NPI 1306821012
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1851900344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CUMMINS DR STE D",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953586411",
            "telephone_number": "510-350-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161704",
            "telephone_number": "630-372-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEP AMERICA -ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "ADMIN VICE PRESIDENT OF OPS",
        "authorized_official_telephone_number": "510-350-2842",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centro Dental Familiar
• Centro Medico la Villita S.C.
• Centro Sanar
• Century Medical Supply LLC
• Century Pho, Inc.
• Cep America Illinois Intensivists
• Egle Cepaitis
• Cepamerica Illinois LLP
• Cepamerica Illinois LLP
• Cepamerica Illinois LLP

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.