MEDICARE: ISAAC LAI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070013175	IL

General Provider Information

NPI Number	:	1730220591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC LAI DPT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:	630-296-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 W BRADLEY PL STE F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4716
Country	:	US
Telephone Number	:	773-799-2795
Fax Number	:	773-799-2791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	02/13/2023

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Directions to “ ISAAC LAI DPT” Practice Location

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