Provider First Line Business Practice Location Address:
PREMISE HEALTH 360 HEALTHCARE
Provider Second Line Business Practice Location Address:
1 WAUKEGAN ROAD
Provider Business Practice Location Address City Name:
NORTH CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-878-7030
Provider Business Practice Location Address Fax Number:
262-878-7024
Provider Enumeration Date:
01/13/2008