Individual
DR. CHARLES A LONGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10400 HALIGUS RD, HUNTLEY, IL 60142-9553
(224) 654-0100
(224) 654-0105
Mailing address
10400 HALIGUS RD, HUNTLEY, IL 60142-9553
(224) 654-0100
(224) 654-0105
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036109417
IL
207P00000X
Emergency Medicine Physician
44365-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43498200
—
WI
01
—
930121753
MEDICARE RAILROAD
WI
01
—
930123615
MEDICARE RAILROAD
WI
01
—
P00153529
MEDICARE RAILROAD
WI
Enumeration date
06/30/2006
Last updated
01/12/2023
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