Search › Illinois › 152W00000X
Jacqlyn Long, O.D
NPI 1992866057 · on the registry since 2006
Practice
- Address
- 211 E Broadway
Alton, IL 62002 - Phone
- (618) 462-9818
- Fax
- (314) 741-4947
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- MO, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2015-02-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois