Provider Demographics
NPI:1326250515
Name:LONG, ERIKA JANE (MHS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:JANE
Last Name:LONG
Suffix:
Gender:F
Credentials:MHS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6S272 SOMERSET CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-3649
Mailing Address - Country:US
Mailing Address - Phone:773-469-0964
Mailing Address - Fax:
Practice Address - Street 1:6S272 SOMERSET CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3649
Practice Address - Country:US
Practice Address - Phone:773-469-0964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008787235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist