Individual
ANDREW LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1321 68TH ST, DOWNERS GROVE, IL 60516-3339
(630) 200-7954
Mailing address
1321 68TH STREET, DOWNERS GROVE, IL 60516
(630) 200-7954
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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