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Organization

CEREESA E. LONGEST MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CEREESA E LONGEST MD (PHYSICIAN)
(847) 253-4040
Entity
Organization

Contact information

Practice address
1100 WEST CENTRAL ROAD, SUITE 205, ARLINGTON HEIGHTS, IL 60005-2465
(847) 253-4040
(847) 253-3028
Mailing address
P.O. BOX 135, 117 S COOK STREET, BARRINGTON, IL 60010-4311
(847) 253-4040
(847) 787-1489

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-090336
STATE LICENSE NUMBER
IL
01
1467438341
TYPE 1 NPI
Enumeration date
01/27/2020
Last updated
09/21/2023
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