Most Relevant Information
Provider Data
| NPI Number: | 1003045071 |
| Provider Name: | TIMOTHY R LONG D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 208M00000X |
| Specialty: | Hospitalist |
| License Number: | 036129689 |
Most Important Dates
| Enumeration Date: | 07/10/2009 |
| Last Updated: | 01/07/2022 |
Provider Practice Location
25 N WINFIELD RD STE 400
WINFIELD
IL
601901379
Practice Location Phone/Fax
| Phone: | 6304567178 |
| Fax: | 6304567486 |
Provider Mailing Location
1860 PAYSPHERE CIR
CHICAGO
IL
606740018
Provider Mailing Phone/Fax
| Phone: | 6304699200 |
| Fax: |