Individual provider Active NPI

Lori Ramine Lightfoot, D.D.S.

  • Dentist
  • Ford Heights, IL
National Provider Identifier
1881802395
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-021027 Issued in IL
Practice address
1645 Cottage Grove Ave
Ford Heights, IL 60411-3818
Phone
(708) 753-5241
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-021027 IL Primary
General Practice Dentistry 1223G0001X 019021027 IL

Addresses

Primary practice location

1645 Cottage Grove Ave
Ford Heights, IL 60411-3818

Mailing address

15547 Ingleside Ave
Dolton, IL 60419-2759
Phone (708) 841-8159

Other identifiers 1

IdentifierTypeStateIssuer
1002723MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llightfoot2@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170510000466 IL Practitioner - Dentist 3375856248 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Apr 8, 2017 Accepting new patients
Cook County CurrentSince Apr 8, 2017 Accepting new patients
Cook County Current Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1900 W Polk St
Ste 1200
Chicago, IL 60612

1645 Cottage Grove Ave
Ford Heights, IL 60411
Phone (708) 753-5800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1881802395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15547 INGLESIDE AVE",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192759",
            "telephone_number": "708-841-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 COTTAGE GROVE AVE",
            "city": "FORD HEIGHTS",
            "state": "IL",
            "postal_code": "604113818",
            "telephone_number": "708-753-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTFOOT",
        "first_name": "LORI",
        "middle_name": "RAMINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-021027",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021027",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002723",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llightfoot2@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ford Heights, IL

Sources for this page

Verify at the official NPI Registry.