Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Longevity Clinical Ltc Associates of Illinois PLLC

Organization Family Medicine Physician · NPI 1407422447

Longevity Clinical Ltc Associates of Illinois PLLC is a Family Medicine Physician in Chicago, Illinois. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6300 N California Ave
Chicago, IL 60659-1702
Phone: (773) 973-1900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X
Family Medicine Physician Taxonomy 207Q00000X
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X
Gerontology Nurse Practitioner Taxonomy 363LG0600X

Record details

NPI number1407422447
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Vincur — Clinical Support Talent Specialist · (561) 815-2427
NPI enumeratedJune 1, 2021
Last updated in NPPESJune 1, 2021
Certification dateJune 1, 2021
Mailing address11770 Us Highway 1 Ste 102e, Palm Beach Gardens, FL 33408-3052

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