Individual
MR. JASON LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5841 S. MARYLAND AVE, UNIVERSITY OF CHICAGO HOSPITALS, CHICAGO, IL 60637
(773) 702-1000
Mailing address
1660 N LASALLE ST, 2811, CHICAGO, IL 60614-6000
(312) 315-6502
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036117184
IL
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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