Provider First Line Business Practice Location Address:
1855 W. TAYLOR ST.
Provider Second Line Business Practice Location Address:
DEPARTMENT OF OTOLARYNGOLOGY H&NS
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-6553
Provider Business Practice Location Address Fax Number:
312-996-4910
Provider Enumeration Date:
09/16/2006