Telisa Long

Private Vehicle · Park Forest, IL

Individual Active NPI

NPI number 1285866111

Practice location

413 Indianwood Blvd
Park Forest, IL 60466-2247
Phone
(708) 369-2368
Fax
(708) 747-5980

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NPI record

NPI
1285866111
Entity type
Individual (Type 1)
Enumeration date
August 11, 2009
Last updated
August 11, 2009
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Private Vehicle Primary 347C00000X L52081680690 IL

About Telisa Long

Telisa Long is a healthcare provider registered in the NPI registry with the primary taxonomy Private Vehicle (code 347C00000X). The practice location is 413 Indianwood Blvd, Park Forest, IL 60466-2247. The NPI number 1285866111 was assigned on August 11, 2009 and the record was last updated on August 11, 2009.

Telisa Long lists a license in the registry: #L52081680690 (IL) for Private Vehicle. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Telisa Long?

The NPI number is 1285866111.

What is the phone number of Telisa Long?

The phone number listed for the practice location is (708) 369-2368.

Where is Telisa Long located?

413 Indianwood Blvd, Park Forest, IL 60466-2247.

What is the taxonomy code for Telisa Long?

The primary taxonomy code is 347C00000X – Private Vehicle.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.