Individual
JOHN LONGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081-1948
(414) 290-6715
Mailing address
111 E WISCONSIN AVE STE 2000, MILWAUKEE, WI 53202-4809
(414) 290-6715
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-059397
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
36059397
IL
207R00000X
Internal Medicine Physician
036-059397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36959397
—
IL
Enumeration date
12/22/2005
Last updated
08/23/2022
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