Provider Demographics
NPI:1730193459
Name:LAI, ROBERT S H (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S H
Last Name:LAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-5916
Mailing Address - Country:US
Mailing Address - Phone:847-802-7090
Mailing Address - Fax:847-802-7095
Practice Address - Street 1:1465 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5916
Practice Address - Country:US
Practice Address - Phone:847-802-7090
Practice Address - Fax:847-802-7095
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036 116997208800000X
ARE-10310208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036116997Medicaid
ILP00373589OtherMEDICARE RAILROAD
IL036116997Medicaid
ILP00373589OtherMEDICARE RAILROAD
ILH25481Medicare UPIN