Provider First Line Business Practice Location Address:
2900 N. LAKE SHORE DRIVE
Provider Second Line Business Practice Location Address:
ST. JOSEPH HOSPITAL DEPARTMENT OF PATHOLOGY
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60657-5640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-613-2475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2008