CEP AMERICA - ILLINOIS SNF, LLP (NPI# 1003375270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003375270 |
| Entity Type | Organization |
| Organization Name | CEP AMERICA - ILLINOIS SNF, LLP |
| Practice Address |
1 Perryman St Lebanon IL 62254-1356 |
| Mailing Address |
1601 Cummins Dr Ste D Modesto CA 95358-6411 |
| Practice Telephone | 6185376165 |
| Mailing Telephone | 5103502600 |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2020-03-30 |
| Authorized Official Name | DAVID BIRDSALL (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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151112 | Cep America - Illinois Snf, LLP | Internal Medicine | 3523 Wickenhauser Ave, Alton, IL 62002-2118 | 2020-03-27 |
| 1891322467 | Cep America - Illinois Snf, LLP | Internal Medicine | 1623 W Delmar Ave, Godfrey, IL 62035-1317 | 2020-03-24 |
| 1104395441 | Cep America - Illinois Snf, LLP | Internal Medicine | 2 Annable Ct, Cahokia, IL 62206-2204 | 2018-11-15 |
| 1215403241 | Cep America - Illinois Snf, LLP | Internal Medicine | 601 W Lincoln Ave, Caseyville, IL 62232-1306 | 2018-10-17 |
| 1003328329 | Cep America - Illinois Snf, LLP | Internal Medicine | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2017-10-26 |
| 1720590045 | Cep America - Illinois Snf, LLP | Internal Medicine | 211 S 3rd St, Belleville, IL 62220-1915 | 2017-10-26 |
| 1295247534 | Cep America - Illinois Snf, LLP | Internal Medicine | 3490 Humbert Rd, Alton, IL 62002-7101 | 2017-10-26 |
| 1942712476 | Cep America - Illinois Snf, LLP | Internal Medicine | 1404 Cross St, Shiloh, IL 62269-2988 | 2017-10-24 |
| 1831601376 | Cep America - Illinois Snf, LLP | Internal Medicine | 2100 Madison Ave, Granite City, IL 62040-4713 | 2017-10-24 |
| 1598277048 | Cep America - Illinois Snf, LLP | Internal Medicine | 4550 Memorial Dr Ste 360, Belleville, IL 62226-5369 | 2017-10-24 |
| Street Address |
1 PERRYMAN ST |
| City | LEBANON |
| State | IL |
| Zip Code | 62254-1356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076021 | David A Weik | Podiatrist | 1 Perryman St, Lebanon, IL 62254-1356 | 2005-07-09 |
| 1245884469 | Cedar Ridge Care and Rehabilitation Center LLC | Skilled Nursing Facility | 1 Perryman St, Lebanon, IL 62254-1356 | 2019-07-25 |
| 1578038402 | Andrea Bahan | Physical Therapist | 1 Perryman St, Lebanon, IL 62254-1356 | 2018-10-08 |
| 1114237575 | Kimberly Ann Wagner | Licensed Practical Nurse | 1 Perryman St, Lebanon, IL 62254-1356 | 2010-10-19 |
| 1740513076 | Jennifer Meyer | Speech-Language Pathologist | 1 Perryman St, Lebanon, IL 62254-1356 | 2009-09-18 |
| 1114130135 | Ashlei L Moses | Physical Therapy Assistant | 1 Perryman St, Lebanon, IL 62254-1356 | 2007-05-07 |
| 1275663445 | Covenant Care Midwest, Inc. | Skilled Nursing Facility | 1 Perryman St, Lebanon, IL 62254-1356 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477788305 | Tonya Gass | Occupational Therapist | 1201 North Alton, Lebanon, IL 62254 | 2009-05-21 |
| 1679550644 | Lebanon Hco, LLC | Skilled Nursing Facility | 1201 N Alton St, Lebanon, IL 62254-1103 | 2005-12-29 |
| 1346873510 | Lebanon Hco, LLC | Skilled Nursing Facility | 1201 N Alton St, Lebanon, IL 62254-1103 | 2020-02-17 |
| 1245475664 | Elizabeth Budd Korte | Family Medicine | 420 Hillcrest Dr, Lebanon, IL 62254-1107 | 2008-12-15 |
| 1467892760 | Christy Nichole Niles | Counselor | 10918 Fallowfield Dr, Lebanon, IL 62254-1163 | 2013-07-01 |
| 1144293820 | William Edward Dill II | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2006-02-10 |
| 1558988519 | Blake Hudspeth | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-25 |
| 1255957544 | Abigail Louise Conner | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-22 |
| 1588280200 | Katy Renee Gayford | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2020-06-18 |
| 1629595509 | Joshua Parker Craig | Specialist/Technologist | 701 College Rd, Lebanon, IL 62254-1291 | 2017-08-23 |
| Find all providers in zip 62254 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1154707511 | Sofia Iqbal | Internal Medicine | 120 Hospital Dr Ste 300, Lebanon, MO 65536-9227 | 2015-08-07 |
| 1174910491 | Yehualashet Bekele Hailemariam | Internal Medicine | 1411 W Baddour Pkwy,lebanon Tn 37087, Lebanon, TN 37087 | 2015-04-24 |
| 1891051892 | Charles Opperman | Internal Medicine | 1470 N Broadway St Ste 130, Lebanon, OH 45036-1762 | 2012-04-04 |
| 1629380159 | Rattanaporn Mahatanan | Internal Medicine | One Meical Center Drive, Dhmc Infectious Disease Department, Lebanon, NH 03756 | 2010-07-13 |
| 1215145404 | Neenos Abd Alnoor | Internal Medicine | 4th & Walnut Street, 2nd Floor, Lebanon, PA 17042-6123 | 2007-05-19 |
| 1154541050 | Integrity Hospitalists Group LLP | Internal Medicine | 206 Babb Drive, Suite C, Lebanon, TN 37087 | 2007-04-26 |
| 1770610800 | Willie Sandoual Cortez | Internal Medicine | 547 East Elm, Lebanon, MO 65536 | 2007-02-27 |
| 1295806750 | Neil R. Schwartzman | Internal Medicine | 441 W Elm St Ste A, Lebanon, MO 65536-3573 | 2006-11-13 |
| 1598853889 | Samina Yousuf Md PC | Internal Medicine | 383 Highland Dr, Lebanon, VA 24266-4632 | 2006-10-11 |
| 1578661443 | Tullahoma Hma Physician Management Inc | Internal Medicine | 124 Public Sq, Lebanon, TN 37087-2734 | 2006-09-21 |
| Find all providers in LEBANON | ||||
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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.