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LONGEVITY CLINICAL LTC ASSOCIATES OF ILLINOIS PLLC
NPI 1407422447
Nurse Practitioner - Primary Care in Chicago, IL

Active since June 01, 2021
6300 N CALIFORNIA AVE, CHICAGO, IL 60659(773) 973-1900 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Longevity Clinical Ltc Associates Of Illinois Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONGEVITY CLINICAL LTC ASSOCIATES OF ILLINOIS PLLC (NPI 1407422447) is a healthcare organization registered as a primary care in Chicago, Illinois and active in the NPI registry since June 2021. The organization lists Diane Vincur, Clinical Support Talent Specialist, as its authorized official.

NPPES Registry Identity

NPI1407422447
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameLONGEVITY CLINICAL LTC ASSOCIATES OF ILLINOIS PLLC
Location Address6300 N CALIFORNIA AVEChicago, IL 60659-1702
Mailing Address11770 Us Highway 1 Ste 102ePalm Beach Gardens, FL 33408-3052 · (561) 444-0788
Phone(773) 973-1900
Organization SubpartNo
Authorized OfficialDiane VincurClinical Support Talent Specialist · (561) 815-2427
Enumeration DateJune 1, 2021
NPPES CertifiedJune 1, 2021
✔ NPI 1407422447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
6300 N CALIFORNIA AVE, Chicago, IL 60659
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASTORIA PLACE SKILLED NURSING FACILITY LLC
Skilled Nursing Facility
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 973-1900
LONGEVITY ACCOUNTABLE CARE, PA
Family Medicine
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 973-1900
ASTORIA PLACE LIVING AND REHABILITATION CENTER LLC
Skilled Nursing Facility
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 973-1900
SALIM A MAZHAR
Physical Therapist
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 465-0040
JENNIFER COULSON OTR/L
Occupational Therapist
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 973-1900
ORTHO REHABILITATION CENTER, INC
Physical Therapist
6300 N CALIFORNIA AVE
CHICAGO, IL 60659
Cook County (773) 465-0040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Longevity Clinical Ltc Associates Of Illinois PLLC's NPI number?

The NPI number for Longevity Clinical Ltc Associates Of Illinois PLLC is 1407422447. It was assigned to this organization in the NPPES registry on June 1, 2021.

Where is Longevity Clinical Ltc Associates Of Illinois PLLC located?

Longevity Clinical Ltc Associates Of Illinois PLLC is located at 6300 N California Ave, Chicago, IL 60659. The listed phone number is (773) 973-1900.

What is Longevity Clinical Ltc Associates Of Illinois PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Longevity Clinical Ltc Associates Of Illinois PLLC was last updated on June 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.