Provider First Line Business Practice Location Address:
5500 N SAINT LOUIS AVE
Provider Second Line Business Practice Location Address:
STUDENT HEALTH SERVICE NEIU E-051
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60625-4625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-442-5800
Provider Business Practice Location Address Fax Number:
773-442-5808
Provider Enumeration Date:
09/08/2010