CEP AMERICA ILLINOIS INTENSIVISTS (NPI# 1386002368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386002368 |
| Entity Type | Organization |
| Organization Name | CEP AMERICA ILLINOIS INTENSIVISTS |
| Practice Address |
4500 Memorial Dr Belleville IL 62226-5360 |
| Mailing Address |
2100 Powell St Suite 900 Emeryville CA 94608-1826 |
| Practice Telephone | 6182237750 |
| Mailing Telephone | 5103502600 |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2016-08-24 |
| Authorized Official Name | THEOPHILE KOURY (ADMINISTRATIVE VP OF OPERATIONS) |
| Authorized Official Telephone | 5103502600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871071837 | Cep America Illinois Intensivists | Internal Medicine | 2233 W Division St, Chicago, IL 60622-8151 | 2018-08-01 |
| 1538661475 | Cep America Illinois Intensivists | Internal Medicine | 503 N Maple St, Effingham, IL 62401-2006 | 2018-03-07 |
| 1528560463 | Cep America Illinois Intensivists | Internal Medicine | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-03-07 |
| 1972005817 | Cep America Illinois Intensivists | Internal Medicine | 12866 Troxler Ave, Highland, IL 62249-2806 | 2018-03-07 |
| 1962904805 | Cep America Illinois Intensivists | Internal Medicine | 200 Health Care Dr, Greenville, IL 62246-1154 | 2018-03-07 |
| 1992204184 | Cep America Illinois Intensivists | Internal Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2018-02-02 |
| Street Address |
4500 MEMORIAL DR |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045568 | Kenneth I Bluestone | Anesthesiology | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2005-07-01 |
| 1558979690 | Protestant Memorial Medical Center, Inc. | Clinical Medical Laboratory | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-07-15 |
| 1841815784 | Kayla Marie Tisza | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-16 |
| 1588289581 | Katie O'rourke | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-15 |
| 1518592203 | Daniela Vetan-zlibut | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-03-03 |
| 1396377289 | Kathryn Cook | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-02-07 |
| 1124650353 | Jessica Stricklin | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5399 | 2020-02-05 |
| 1396375788 | Emily Jean Sloan | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-01-24 |
| 1629639695 | Nicholas Raburn | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-06-21 |
| 1124582523 | Jenna Dornak | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104075035 | Yashaswi S Belvadi | Internal Medicine | 211 S 3rd St, Belleville, IL 62220-1915 | 2008-09-16 |
| 1780735308 | Barbara Ann Sudholt | Internal Medicine | 340 W Lincoln St Ste 300, Belleville, IL 62220-1900 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861970626 | Suburban Pulmonary & Critical Care Assoc, Inc | Internal Medicine | 3 Erie Ct Ste 7010, Oak Park, IL 60302-2519 | 2018-08-03 |
| 1265883441 | Kunal H. Patel | Internal Medicine | 9600 Gross Point Rd. Im/icu Hospitalists, Skokie, IL 60076-1900 | 2016-06-28 |
| 1760896633 | Zohaib Akhtar | Internal Medicine | 301 S Park Ave, Herrin, IL 62948-3603 | 2014-06-18 |
| 1699187344 | Said Abuhasna | Internal Medicine | 800 Biesterfield Rd Ste 105, Elk Grove Village, IL 60007-3372 | 2014-05-29 |
| 1053678755 | Nida Junaid | Internal Medicine | 305 W Jackson St Ste 301, Carbondale, IL 62901-1474 | 2012-04-18 |
| 1730446998 | Steven Jay Quinn | Internal Medicine | 11900 Southwest Hwy Ste 101, Palos Park, IL 60464 | 2012-04-12 |
| 1588970933 | Farbod Ghods | Internal Medicine | 5841 S Maryland Ave # Mc6026, Chicago, IL 60637-1447 | 2010-08-24 |
| 1225340045 | Praveen R. Anegondhi Sudhindra | Internal Medicine | 5401 N Knoxville Ave Ste 412b, Peoria, IL 61614-5082 | 2010-07-09 |
| 1588984454 | James M Walter | Internal Medicine | 240 East Huron, Mcgaw M-300, Chicago, IL 60611 | 2010-06-02 |
| 1568789485 | Suleman A Umar | Internal Medicine | 4440 W 95th St Rm 190s, Oak Lawn, IL 60453-2600 | 2010-05-03 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.