Provider First Line Business Practice Location Address:
HINES VA HOSPITAL, ROOSEVELT RD AND 5TH AVE
Provider Second Line Business Practice Location Address:
BUILDING ONE, ROOM F201, ROUTING NUMBER 127
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:
708-202-2844
Provider Business Practice Location Address Fax Number:
708-202-7936
Provider Enumeration Date:
09/07/2006