Individual provider Active NPI

Lyndsay Danielle Long Vance, DO

  • Pediatrics Physician
  • Oak Lawn, IL
National Provider Identifier
1396373908
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1396373908 Issued in IL
Practice address
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone
(708) 684-8000
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1396373908 IL Primary
Neonatal-Perinatal Medicine Physician 2080N0001X DOS-2402 HI

Addresses

Primary practice location

4440 W 95TH St
Oak Lawn, IL 60453-2600

Mailing address

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Other practice location 1

1319 Punahou St
Honolulu, HI 96826-1080
Phone (808) 983-6000

Other practice location 2

67-1125 Mamalahoa Hwy
Kamuela, HI 96743-8496
Phone (808) 885-4444

Other names 1

  • Lyndsay Danielle Long Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718003292 HI Practitioner - Pediatric MedicinePractitioner - Hospitalist 4789120460 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1396373908ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kapiolani Medical Specialists CurrentSince Mar 17, 2025 Accepting new patients
Queens University Medical Group CurrentSince Aug 29, 2024 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Jul 29, 2024 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jul 22, 2024 Accepting new patients
North Hawaii Community Hospital CurrentSince Jul 22, 2024 Accepting new patients

Locations

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1396373908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 Punahou St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968261080",
            "country_code": "US",
            "telephone_number": "808-983-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67-1125 Mamalahoa Hwy",
            "address_purpose": "LOCATION",
            "city": "Kamuela",
            "state": "HI",
            "postal_code": "967438496",
            "country_code": "US",
            "telephone_number": "808-885-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG VANCE",
        "first_name": "LYNDSAY",
        "middle_name": "DANIELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "1396373908",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "HI",
            "license": "DOS-2402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDSAY",
            "last_name": "LONG",
            "middle_name": "DANIELLE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.