CATHY EVANS LONGOS (NPI# 1114088812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114088812 |
| Entity Type | Individual |
| Full Name | CATHY EVANS LONGOS |
| Other Name | CATHERINE ELIZABETH EVANS |
| Credential | DMD |
| Practice Address |
22a Glen Ed Professional Park Glen Carbon IL 62034 |
| Practice Telephone | 6186567615 |
| Mailing Telephone | 6186567615 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2016-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019021729 | IL | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
021001620 | IL | Dental Providers |
| Street Address |
22A GLEN ED PROFESSIONAL PARK |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396755120 | John Frederick Hatton | Dentist | 22a Glen Ed Professional Park, Glen Carbon, IL 62034-3333 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396755120 | John Frederick Hatton | Dentist | 22a Glen Ed Professional Park, Glen Carbon, IL 62034-3333 | 2006-08-08 |
| 1285651703 | Roxanne Patricia Benison | Dentist | 22 Glen Ed Professional Park Ste B, Glen Carbon, IL 62034-3300 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089777 | Sebastian Przybylo, Dmd, Pllc | Dentist | 350 S Northwest Hwy Ste 116, Park Ridge, IL 60068-4262 | 2020-09-24 |
| 1770126740 | Old Orchard Endodontics | Dentist | 4905 Old Orchard Ctr Ste 216, Skokie, IL 60077-4741 | 2019-10-23 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1134782592 | Endodontics of Springfield | Dentist | 997 Clock Tower Dr Ste C, Springfield, IL 62704-1399 | 2019-04-20 |
| 1942793815 | Millennium Dental Specialist | Dentist | 1624 W Division St Ste B, Chicago, IL 60622-3908 | 2018-06-14 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1518488055 | Seth Thomas Barnett | Dentist | 3601 General Electric Rd Ste 6, Bloomington, IL 61704-8566 | 2017-07-06 |
| 1023562857 | Jwwdental LLC | Dentist | 808 E Woodfield Rd, Suite 300, Schaumburg, IL 60173-4816 | 2016-08-10 |
| 1629453378 | Charles Richard Neach | Dentist | 801 S Paulina St Rm 302a, Chicago, IL 60612-7210 | 2015-07-23 |
| 1619360096 | Rajan Sharma | Dentist | 6319 Fairview Ave Ste 103, Westmont, IL 60559-2889 | 2015-03-10 |
| Find all providers with the same taxonomy | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.