Dennis A. Long, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

3642582 Issued in IL

Practice address

2210 Dean St
Suite O-1
Saint Charles, IL 60175-1066

Phone

(630) 377-7660

NPI assigned

Mar 13, 2007

Last updated

Nov 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Dennis a. Long, M.D., S.C.

  • Psychiatry Physician
  • St Charles, IL
  • NPI 1023293586
  Authorized official Same address or phone

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1154454692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 DEAN ST",
            "address_2": "SUITE O-1",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601751066",
            "telephone_number": "630-377-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 DEAN ST",
            "address_2": "SUITE O-1",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601751066",
            "telephone_number": "630-377-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DENNIS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "3642582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay Foley Lofgren, MA, LCPC
• Maureen Convey McGinnis Logsdon, LCSW
• Amelia Blossom Lomas, LPC
• Amanda Lombardo, BCBA, IBA
• Katherine London
• Melanie Elizabeth Long
• Robert Wayne Long, D.O.
• Longevity Health and Fitness, Inc. (Longevity Health and Fitness)
• Longevity Strength and Wellness Center LLC
• Christian Lopez, DPT

• Psychiatry Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.