Provider First Line Business Practice Location Address:
3001 GREEN BAY ROAD MAIL CODE 111
Provider Second Line Business Practice Location Address:
NORTH CHICAGO VA MEDICAL CENTER EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
NORTH CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-688-1900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2006