Individual
DR. LORI RAMINE LIGHTFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1645 COTTAGE GROVE AVE, FORD HEIGHTS, IL 60411-3818
(708) 753-5241
Mailing address
15547 INGLESIDE AVE, DOLTON, IL 60419-2759
(708) 841-8159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-021027
IL
1223G0001X
General Practice Dentistry
019021027
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002723
—
IL
Enumeration date
05/18/2007
Last updated
04/26/2021
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