Provider First Line Business Practice Location Address:
JESSE BROWN VAMC; 820 S. DAMEN AVE.
Provider Second Line Business Practice Location Address:
DEPARTMENT OF RADIOLOGY; ROOM NUMBER 4436
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-3728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-569-7735
Provider Business Practice Location Address Fax Number:
312-569-8102
Provider Enumeration Date:
09/20/2006