Longevity Clinical Ltc Associates of Illinois PLLC
NPI 1407422447ActiveOrganization· Nurse Practitioner, Primary Care· Chicago, IL
Nurse Practitioner, Primary Care in Chicago, Illinois, registered in NPPES in June 2021. The authorized official on file is Diane Vincur, Clinical Support Talent Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1407422447 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 1, 2021 |
| Last updated in NPPES | Jun 1, 2021 |
| Certified by provider | Jun 1, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Family Medicine, Geriatric Medicine | 207QG0300X | — | — |
| Nurse Practitioner, Gerontology | 363LG0600X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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