Individual provider Active NPI

Melissa J. Long, APN-CNP

  • Nurse Practitioner
  • Long Grove, IL
National Provider Identifier
1649619768
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209010475 Issued in IL
Practice address
3880 Salem Lake Dr
F
Long Grove, IL 60047-5292
Phone
(847) 719-2220
Fax
(847) 719-2265
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209010475 IL Primary
Family Nurse Practitioner 363LF0000X 209010475 IL

Addresses

Primary practice location

3880 Salem Lake Dr
F
Long Grove, IL 60047-5292

Mailing address

22285 N Pepper Rd Ste 401
Lake Barrington, IL 60010-2542
Phone (847) 839-4391

Other identifiers 1

IdentifierTypeStateIssuer
209010475MedicaidIL

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
I20140224001675 IL Practitioner - Nurse Practitioner 3779713540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

777 Park Ave W
Highland Park, IL 60035-2433

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 8, 2018 Accepting new patients
Northwest Neurology, LTD CurrentSince Jul 1, 2019 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Rm 4945
Evanston, IL 60201
Phone (847) 570-2428

2100 Pfingsten Rd
Rm 4812
Glenview, IL 60026

2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800

777 Park Ave W
Rm 2104
Highland Park, IL 60035

777 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3744

22285 N Pepper Rd
Ste 401
Lake Barrington, IL 60010
Phone (847) 882-6604

1 E County Line Rd
Sandwich, IL 60548
Phone (815) 786-2722

9600 Gross Point Rd
Rm 2553
Skokie, IL 60076

9600 Gross Point Rd
Skokie, IL 60076
Phone (847) 677-9600

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 3

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 1

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1649619768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD STE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102542",
            "telephone_number": "847-839-4391",
            "fax_number": "847-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR",
            "address_2": "F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MELISSA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010475",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209010475",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

Verify at the official NPI Registry.