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NPI Code Detail

MEDICARE: DR. ROBERT J LONGO MD

MEDICARE: DR. ROBERT J LONGO 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
1208M00000XHospitalist Physician036089997IL
2207R00000XInternal Medicine Physician036089997IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265437230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT J LONGO MD
Provider Business Mailing Address
First Line : 3880 SALEM LAKE DR
Second Line : STE F
City : LONG GROVE
State : IL
Zip : 60047-5292
Country : US
Telephone Number : 847-719-2220
Fax Number : 847-719-2265
Provider Business Practice Location Address
First Line : 3880 SALEM LAKE DR
Second Line : STE F
City : LONG GROVE
State : IL
Zip : 60047-5292
Country : US
Telephone Number : 847-719-2220
Fax Number : 847-719-2265
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 03/07/2023

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Directions to “ DR. ROBERT J LONGO MD” Practice Location

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