Individual
LORI R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 S WAUKEGAN RD, LAKE FOREST, IL 60045-2654
(847) 234-8866
(847) 234-4682
Mailing address
2650 RIDGE AVE # 1223, EVANSTON, IL 60201-1700
(847) 982-3175
(847) 982-3394
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036119598
IL
Other
Enumeration date
05/03/2007
Last updated
01/26/2026
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