Individual provider Active NPI

Dymond Long, APN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1114463049
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277001290 Issued in IL
Practice address
1715 E 95TH St
Chicago, IL 60617-4708
Phone
(773) 768-4437
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015381 IL
Family Nurse Practitioner 363LF0000X 277001290 IL Primary

Addresses

Primary practice location

1715 E 95TH St
Chicago, IL 60617-4708

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 352-1515

Other practice location 1

17730 Oak Park Ave Ste B
Tinley Park, IL 60477-2065
Phone (708) 998-5542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112000180 IL Practitioner - Nurse Practitioner 3173807625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1715 E 95TH St
Chicago, IL 60617-4708
Phone (312) 733-9730

Hospital & facility affiliations

  • Premier Point Home Health, Inc Home health agency, Chicago, IL, CCN 148025
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209015381ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Apr 9, 2018 Accepting new patients

Locations

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

1715 E 95th St
Chicago, IL 60617
Phone (773) 768-4437

Interoperability endpoints

  • Direct secure messaging: dymond.long@oakstreethealth.gwaydirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1114463049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174708",
            "telephone_number": "773-768-4437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17730 Oak Park Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604772065",
            "country_code": "US",
            "telephone_number": "708-998-5542",
            "fax_number": "708-377-3940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "DYMOND",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015381",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.