Provider First Line Business Practice Location Address:
2160 S. FIRST AVENUE
Provider Second Line Business Practice Location Address:
LOYOLA UNIVERSITY MEDICAL CENTER 2160 S. FIRST AVENUE
Provider Business Practice Location Address City Name:
MAYWOOD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-584-1888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2010