Zachary James Long, MD
Family Medicine in Chicago, IL. Individual provider (NPI-1).
NPI number1669977104
StatusActive
Last updated in NPPESJun 26, 2024
Details
- NPI
- 1669977104
- Entity type
- Individual (NPI-1)
- Name
- Zachary James Long
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2018
- Certification date
- Jun 26, 2024
- Last updated
- Jun 26, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 036.156666 | IL | Yes |
Practice location
3245 N Halsted StChicago, IL 60657-3419
Phone 773-388-1600 · Fax 773-388-8936
Mailing address
3421 Northview DrJackson, MS 39216-3112
Phone 601-927-8822
Other practice locations
4600 N Ravenswood Ave
Chicago, IL 60640-4510
Chicago, IL 60640-4510
Phone 773-561-7500
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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