MEDICARE: CEP AMERICA - ILLINOIS SNF, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1104395441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEP AMERICA - ILLINOIS SNF, LLP

Provider Business Mailing Address
First Line	:	1601 CUMMINS DR STE D
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95358-6411
Country	:	US
Telephone Number	:	510-350-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 ANNABLE CT
Second Line	:
City	:	CAHOKIA
State	:	IL
Zip	:	62206-2204
Country	:	US
Telephone Number	:	618-332-0114
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE VP OF OPERATIONS
Name	:	THEOPHILE KOURY
Credential	:	M.D
Telephone Number	:	510-350-2600

Provider Enumeration Date	:	11/15/2018
Last Update Date	:	03/30/2020

Similar Medicare Providers

1407820228 — CAHOKIA NURSING AND REHABILITATION CENTER
Practice Location Address:

2 ANNABLE CT
CAHOKIA, IL
62206-2204

Practice Phone: 618-332-0114
Practice Fax: 618-332-1043

1306011051 — CAHOKIA NURSING AND REHABILITATION CENTER
Practice Location Address:

2 ANNABLE CT
CAHOKIA, IL
62206-2204

Practice Phone: 847-982-2300
Practice Fax: 847-982-2304

1629339288 — MS. STEPHANIE PAIGE MOYER
Practice Location Address:

2 ANNABLE CT
CAHOKIA, IL
62206-2204

Practice Phone: 618-332-0114
Practice Fax:

1467713891 — MRS. SHARON CHARLENE UTTERBACK LPTA
Practice Location Address:

2 ANNABLE CT
CAHOKIA, IL
62206-2204

Practice Phone: 618-332-7710
Practice Fax: 618-332-7710

1073452009 — CAHOKIA REHABILITATION AND NURSING LLC
Practice Location Address:

2 ANNABLE CT
CAHOKIA HEIGHTS, IL
62206-2204

Practice Phone: 618-332-0114
Practice Fax:

1891784823 — DR. STEVEN G CONNORS DC
Practice Location Address:

1518 CAMP JACKSON RD
CAHOKIA, IL
62206

Practice Phone: 618-337-5700
Practice Fax: 618-337-7109

Directions to “CEP AMERICA - ILLINOIS SNF, LLP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.