Provider First Line Business Practice Location Address:
HINES VA HOSPITAL, 1ST AVE & ROOSEVELT ROAD
Provider Second Line Business Practice Location Address:
PSYCHOLOGY SERVICE (116B)
Provider Business Practice Location Address City Name:
HINES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60141-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-202-2475
Provider Business Practice Location Address Fax Number:
707-202-2687
Provider Enumeration Date:
08/01/2006