Provider First Line Business Practice Location Address:
5145 N. CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
SWEDISH HOSPITAL PART OF NORTHSHORE
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-989-3808
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2022