DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: NICOLE KATHRYN LONG MD

MEDICARE: NICOLE KATHRYN LONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramIL

General Provider Information

NPI Number : 1518531946
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE KATHRYN LONG MD
Provider Business Mailing Address
First Line : 1500 S FAIRFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 321-352-0994
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S FAIRFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 321-352-0994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2021
Last Update Date : 01/14/2026

Similar Medicare Providers

1144637380 — CHAUDHARY FAIZAN AHMED M.D
Practice Location Address:
1500 S FAIRFIELD AVE
CHICAGO, IL
60608-1782
Practice Phone: 773-542-2000
Practice Fax:
1679862296 — MOHAMMED MOHSIN KHADIR M.D.
Practice Location Address:
1500 S FAIRFIELD AVE
CHICAGO, IL
60608-1782
Practice Phone: 773-542-2000
Practice Fax:
1861491250 — ERICA ANNETTE GUZALO M.D.
Practice Location Address:
1500 S FAIRFIELD AVE
CHICAGO, IL
60608-1782
Practice Phone: 773-542-2000
Practice Fax:
1871581314 — MOUNT SINAI HOSPITAL MEDICAL CENTER
Practice Location Address:
1500 S FAIRFIELD AVE
CHICAGO, IL
60608-1782
Practice Phone: 773-542-2000
Practice Fax:
1952356701 — CHERISE BARRON PA
Practice Location Address:
1500 S FAIRFIELD AVE # C1500
CHICAGO, IL
60608-1782
Practice Phone: 773-257-6663
Practice Fax:
1881818326 — DR. AMIR HOSSEIN VAFA MD
Practice Location Address:
1500 S FAIRFIELD AVE
CHICAGO, IL
60608-1782
Practice Phone: 773-257-6464
Practice Fax:

Directions to “ NICOLE KATHRYN LONG MD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.