Provider First Line Business Practice Location Address:
5757 NORTH LINCOLN AVE
Provider Second Line Business Practice Location Address:
SUITE 27, DIVERSIFIED EMERGENCY SERVICES LLC
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-728-5133
Provider Business Practice Location Address Fax Number:
773-728-5134
Provider Enumeration Date:
01/23/2007