Provider Demographics
NPI:1518135052
Name:LEIDER, ROBERT JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:LEIDER
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 1:1560 N. SANDBURG TERRACE
Mailing Address - Street 2:APARTMENT 3515
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7733
Mailing Address - Country:US
Mailing Address - Phone:312-337-0809
Mailing Address - Fax:
Practice Address - Street 1:1560 N. SANDBURG TERRACE
Practice Address - Street 2:APARTMENT 3515
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7733
Practice Address - Country:US
Practice Address - Phone:312-337-0809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0346872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry