Individual
DR. LAURA LYNN LONG
Active
Individual
DR. LAURA LYNN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036114793
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K53376
MEDICARE PTAN
IL
Enumeration date
01/23/2007
Last updated
04/17/2025
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