Individual
DR. DENNIS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DHSC, CCP
Contact information
Practice address
1440 CIRCLE DR, GLENDALE HEIGHTS, IL 60139-3310
(847) 722-3830
Mailing address
1440 CIRCLE DR, GLENDALE HEIGHTS, IL 60139-3310
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
214000255
IL
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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