Provider First Line Business Practice Location Address:
2211 NORTH OAK PARK AVENUE
Provider Second Line Business Practice Location Address:
SHRINERS HOSPITAL FOR CHILDREN CHICAGO
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60707-3392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-385-5492
Provider Business Practice Location Address Fax Number:
773-385-5488
Provider Enumeration Date:
08/18/2006