Provider First Line Business Practice Location Address:
1900 W POLK ST, 10TH FLOOR
Provider Second Line Business Practice Location Address:
DEPT. OF EMERGENCY MEDICINE
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:
312-864-1521
Provider Business Practice Location Address Fax Number:
312-864-9656
Provider Enumeration Date:
12/06/2006