Individual
DR. JOE LOUIS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
42 BRIARCLIFF PROFESSIONAL CENTER, BOURBONNAIS, IL 60914
(815) 932-1116
(815) 932-9919
Mailing address
42 BRIARCLIFF PROFESSIONAL CENTER, BOURBONNAIS, IL 60914
(815) 932-1116
(815) 932-9919
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
466630
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073647293
NPI GROUP
IL
Enumeration date
11/24/2006
Last updated
03/26/2008
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