| Cep America - Illinois Snf, Llp | |
|
150 N 27th St Belleville IL 62226-6621 | |
| (618) 235-6600 | |
| Not Available |
| Full Name | Cep America - Illinois Snf, Llp |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 N 27th St, Belleville, Illinois |
| Authorized Official Name and Position | Theophile Koury (ADMINISTRATIVE VP OF OPERATIONS) |
| Authorized Official Contact | 5103502600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cep America - Illinois Snf, Llp 2100 Powell St Ste 900 Emeryville CA 94608-1826 Ph: (510) 350-2600 | Cep America - Illinois Snf, Llp 150 N 27th St Belleville IL 62226-6621 Ph: (618) 235-6600 |
| NPI Number | 1073069415 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 11/16/2016 |
| Medicare PECOS PAC ID | 8022306737 |
|---|---|
| Medicare Enrollment ID | O20161012002933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073069415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ann Marie Hagedorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245237825 PECOS PAC ID: 1850339581 Enrollment ID: I20050421001470 |
| Provider Name | Leopoldo S. Pardo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114913274 PECOS PAC ID: 4688608904 Enrollment ID: I20050926000332 |
| Provider Name | Mary A Mioux Berry |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1023014750 PECOS PAC ID: 2860412368 Enrollment ID: I20051129000821 |
| Provider Name | Asim I Elmahboub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316984859 PECOS PAC ID: 4284538893 Enrollment ID: I20070314000259 |
| Provider Name | Satyen Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154482131 PECOS PAC ID: 8527142777 Enrollment ID: I20080226000675 |
| Provider Name | Anshu Sood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659598225 PECOS PAC ID: 6608934666 Enrollment ID: I20081020000239 |
| Provider Name | Hana Filipova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619129632 PECOS PAC ID: 4880741578 Enrollment ID: I20090415000582 |
| Provider Name | Behfar Dianati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558580852 PECOS PAC ID: 4789785775 Enrollment ID: I20091006000307 |
| Provider Name | Ashley H Malcolm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205030913 PECOS PAC ID: 8224164025 Enrollment ID: I20100331000731 |
| Provider Name | Ibrahim B Elayyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023207115 PECOS PAC ID: 6507051943 Enrollment ID: I20101111000738 |
| Provider Name | Andrew Mahtani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659579613 PECOS PAC ID: 4880882687 Enrollment ID: I20101221000445 |
| Provider Name | Sara A Mchale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235399304 PECOS PAC ID: 9830368075 Enrollment ID: I20110804000607 |
| Provider Name | Mary C Rybak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962665059 PECOS PAC ID: 5092985085 Enrollment ID: I20110830000758 |
| Provider Name | Joshua A Niebruegge |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710140645 PECOS PAC ID: 5193990083 Enrollment ID: I20111205000208 |
| Provider Name | Crystal M Carmicheal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619138682 PECOS PAC ID: 9739347279 Enrollment ID: I20120229000864 |
| Provider Name | Pankaj Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376771105 PECOS PAC ID: 8123211919 Enrollment ID: I20130110000495 |
| Provider Name | Deanna L Rodenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013265248 PECOS PAC ID: 0446404982 Enrollment ID: I20130208000102 |
| Provider Name | Khaled Jumean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134351448 PECOS PAC ID: 5294881611 Enrollment ID: I20130313000301 |
| Provider Name | Bobby R Blum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235403643 PECOS PAC ID: 7618139106 Enrollment ID: I20130503000198 |
| Provider Name | Payton Mcgowen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629381256 PECOS PAC ID: 5597905935 Enrollment ID: I20130709000381 |
| Provider Name | Naveenkumar B Krishna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417180704 PECOS PAC ID: 6709010085 Enrollment ID: I20130930000477 |
| Provider Name | Mary C Littlejohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255779955 PECOS PAC ID: 3577795806 Enrollment ID: I20140421000127 |
| Provider Name | Changqing Zhao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700183142 PECOS PAC ID: 5698992311 Enrollment ID: I20140804001345 |
| Provider Name | Jemila Maxine Crawford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154683860 PECOS PAC ID: 6103137419 Enrollment ID: I20150612000774 |
| Provider Name | Michael G Guignon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942542931 PECOS PAC ID: 3779886791 Enrollment ID: I20160630001414 |
| Provider Name | Seema Verma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326380908 PECOS PAC ID: 4385946722 Enrollment ID: I20160725000214 |
| Provider Name | Crystal Vaughn Kondowe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366702870 PECOS PAC ID: 7618192428 Enrollment ID: I20160906000126 |
| Provider Name | Christopher G Engele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013464031 PECOS PAC ID: 8729367487 Enrollment ID: I20161121000858 |
| Provider Name | Kelly Denise Riney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205375151 PECOS PAC ID: 9133405749 Enrollment ID: I20170414000317 |
| Provider Name | Kamran Hussaini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215347125 PECOS PAC ID: 5597067918 Enrollment ID: I20170515000418 |
| Provider Name | Therese Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336670454 PECOS PAC ID: 3870865702 Enrollment ID: I20170828000727 |
| Provider Name | Maaroof Islam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548656747 PECOS PAC ID: 0042512907 Enrollment ID: I20180810002159 |
| Provider Name | Nicole Renee Nissen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629569843 PECOS PAC ID: 0547519423 Enrollment ID: I20180910002278 |
| Provider Name | Bijan Naghibi Harat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548788524 PECOS PAC ID: 9638444771 Enrollment ID: I20180912003693 |
| Provider Name | Elizabeth J Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164832705 PECOS PAC ID: 9537054622 Enrollment ID: I20190226001626 |
| Provider Name | Adebunmi Ojulari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538510458 PECOS PAC ID: 2567750052 Enrollment ID: I20190711001977 |
| Provider Name | Leann Nitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952701666 PECOS PAC ID: 2769709658 Enrollment ID: I20190816001914 |
| Provider Name | Lavada Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164691945 PECOS PAC ID: 8921184813 Enrollment ID: I20191002001731 |
| Provider Name | Alice Halliday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245871243 PECOS PAC ID: 2769814946 Enrollment ID: I20191108000253 |
| Provider Name | Robin Marion Gunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578199980 PECOS PAC ID: 0547699084 Enrollment ID: I20200403000520 |
| Provider Name | Amber Criswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174146906 PECOS PAC ID: 0042631772 Enrollment ID: I20200604000191 |
| Provider Name | Vincent J Duenas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083142152 PECOS PAC ID: 6901171354 Enrollment ID: I20200730002896 |
| Provider Name | Anum Niazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679005730 PECOS PAC ID: 1052651197 Enrollment ID: I20200903003295 |
| Provider Name | Gregory Bismack |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619293149 PECOS PAC ID: 2466604921 Enrollment ID: I20210512002587 |
| Provider Name | Sarah Halliday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487113999 PECOS PAC ID: 7911249867 Enrollment ID: I20220217001169 |
| Provider Name | Junaid Munshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629411129 PECOS PAC ID: 1254657216 Enrollment ID: I20221208002975 |
| Provider Name | Adnan Shahid Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558865097 PECOS PAC ID: 8628324852 Enrollment ID: I20230606002178 |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Ste 160, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 | |
Pc Associates ,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Drive, Ste. 220, Belleville, IL 62226 Phone: 618-235-6191 Fax: 618-235-6716 | |
Healthcare Physicians Of Southern Illinois, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Suite 100, Belleville, IL 62226 Phone: 618-222-9999 Fax: 618-222-9337 | |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr Ste 400, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Albarcha Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 Fax: 618-355-9972 |