Individual
DR. WILLIAM P LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
215 E 1ST ST, DIXON, IL 61021
(815) 288-7711
(815) 285-8930
Mailing address
215 E 1ST ST, DIXON, IL 61021-3166
(815) 288-7711
(815) 285-8930
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-098381
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098381
—
IL
01
—
K05115
MEDICARE
IL
Enumeration date
03/08/2006
Last updated
08/27/2018
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