Provider First Line Business Practice Location Address:
11601 S PULASKI RD
Provider Second Line Business Practice Location Address:
WORTH TOWNSHIP CLINIC
Provider Business Practice Location Address City Name:
ALSIP
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60803-1611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-371-3393
Provider Business Practice Location Address Fax Number:
708-371-2542
Provider Enumeration Date:
09/07/2006