Provider First Line Business Practice Location Address:
HINES VA HOSPITAL
Provider Second Line Business Practice Location Address:
5TH AVE & ROOSEVELT ROAD
Provider Business Practice Location Address City Name:
HINES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-202-2169
Provider Business Practice Location Address Fax Number:
708-202-2292
Provider Enumeration Date:
08/17/2006