Provider First Line Business Practice Location Address:
1900 E MAIN
Provider Second Line Business Practice Location Address:
ILLIANA HEALTH CARE SYSTEM
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-554-4846
Provider Business Practice Location Address Fax Number:
217-584-4903
Provider Enumeration Date:
09/28/2006