Individual provider Active NPI

John Dale Lightfoot, M.D.

  • Family Medicine Physician
  • Rolling Meadows, IL
National Provider Identifier
1962441659
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036061369 Issued in IL
Practice address
1941 Rohlwing Rd
Rolling Meadows, IL 60008-1338
Phone
(847) 618-0850
Fax
(847) 618-0859
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036061369 IL Primary

Addresses

Primary practice location

1941 Rohlwing Rd
Rolling Meadows, IL 60008-1338

Mailing address

1941 Rohlwing Rd
Rolling Meadows, IL 60008-1338
Phone (847) 618-0850

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlightfoot14697@direct.nch.org

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000222 IL Practitioner - Family Practice 0042242646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036061369ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Services Inc Family Medicine CurrentSince Sep 1, 2011 Accepting new patients
Northwest Community Health Services Inc CurrentSince Sep 1, 2011 Accepting new patients
Northwest Family Physicians LLC Family Medicine CurrentSince Jun 30, 1986 Accepting new patients

Locations

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1700 W Central Rd
Ste 140
Arlington Hts, IL 60005
Phone (312) 259-6200

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

25233 Network Pl
Chicago, IL 60673

1941 Rohlwing Rd
Rolling Meadows, IL 60008
Phone (847) 618-0850

Interoperability endpoints

  • Direct secure messaging: jlightfoot14697@direct.nch.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1962441659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 ROHLWING RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081338",
            "telephone_number": "847-618-0850",
            "fax_number": "847-618-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 ROHLWING RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600081338",
            "telephone_number": "847-618-0850",
            "fax_number": "847-618-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTFOOT",
        "first_name": "JOHN",
        "middle_name": "DALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036061369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlightfoot14697@direct.nch.org",
            "affiliation": "N",
            "address_1": "1941 Rohlwing Rd",
            "city": "Rolling Meadows",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600081338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

Verify at the official NPI Registry.