Provider First Line Business Mailing Address:
225 E CHICAGO AVE BOX 161
Provider Second Line Business Mailing Address:
LURIE CHILDREN'S HOSPITAL, DIV OF ADOLESCENT MEDICINE
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60611-2991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number: