Provider First Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
3001 GREENBAY RD
Provider Business Practice Location Address City Name:
NORTH CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60064-3048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-688-1900
Provider Business Practice Location Address Fax Number:
224-610-3828
Provider Enumeration Date:
08/03/2006