Individual
JENNIFER LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
444 N EOLA RD, UNIT 110, AURORA, IL 60502-9615
(630) 692-5660
(630) 692-5661
Mailing address
2040 OGDEN AVE, SUITE 313, AURORA, IL 60504-7206
(630) 499-2404
(630) 499-2399
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041376253
IL
363L00000X
Nurse Practitioner
Primary
209013052
IL
363LF0000X
Family Nurse Practitioner
209013052
IL
Other
Enumeration date
08/13/2015
Last updated
04/01/2025
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