Individual
DILANE LOFTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4324 176TH PL, COUNTRY CLUB HILLS, IL 60478-4750
(708) 238-8152
Mailing address
4324 176TH PL, COUNTRY CLUB HILLS, IL 60478-4750
(708) 238-8152
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
851909879
—
IL
Enumeration date
01/24/2023
Last updated
01/26/2023
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