Provider First Line Business Practice Location Address:
3249 S. OAK PARK AVE
Provider Second Line Business Practice Location Address:
MACNEAL HOSPITAL
Provider Business Practice Location Address City Name:
BERWYN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-783-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2005