Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. TELISA LONG
Active Sole ProprietorMS. TELISA LONG is a Private Vehicle healthcare provider located in PARK FOREST, Illinois. NPI 1285866111 is currently active in the NPPES registry. Verify at CMS.
Private Vehicle · PARK FOREST, IL
Registration Details
- NPI Number
- 1285866111
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 11, 2009 (17.024524314149 yrs)
- Last Updated
- Aug 11, 2009
- License
-
L52081680690 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
413 INDIANWOOD BLVDPARK FOREST, IL, 604662247Browse IL providers · Browse ZIP 60466
- Phone
- 7083692368
- Fax
- 7087475980
- Primary Specialty
-
Private Vehicle
347C00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.