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Individual

ROBERT P LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Mailing address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036143792
IL
207P00000X
Emergency Medicine Physician
81526-21
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036143792
IL
05
1720407430
WI
Enumeration date
04/09/2014
Last updated
04/03/2026
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