Provider First Line Business Practice Location Address:
840 SOUTH WOOD STREET, 130 CSN
Provider Second Line Business Practice Location Address:
UIC DEPARTMENT OF PATHOLOGY (MC847)
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:
312-413-9003
Provider Business Practice Location Address Fax Number:
312-996-7586
Provider Enumeration Date:
04/01/2008