Provider First Line Business Practice Location Address:
225 EAST CHICAGO AVENUE
Provider Second Line Business Practice Location Address:
LURIE CHILDRENS HOSPITAL 14TH FLOOR NICU
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-917-9956
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2013