Healthcare Provider Details

I. General information

NPI: 1205978186
Provider Name (Legal Business Name): ROBERT LENET M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 EAST HURON ST SUITE 1226
CHICAGO IL
60611-2946
US

IV. Provider business mailing address

150 EAST HURON ST SUITE 1226
CHICAGO IL
60611-2946
US

V. Phone/Fax

Practice location:
  • Phone: 312-951-0501
  • Fax: 312-951-0970
Mailing address:
  • Phone: 312-951-0501
  • Fax: 312-951-0970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036070579
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: