Provider First Line Business Practice Location Address:
2410 SAMPSON ST. (FISHER HEALTH CLINIC/NHC-503)
Provider Second Line Business Practice Location Address:
NAVAL HEALTH CLINIC GREAT LAKES
Provider Business Practice Location Address City Name:
GREAT LAKES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60088-2942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-688-6712
Provider Business Practice Location Address Fax Number:
847-688-3860
Provider Enumeration Date:
12/21/2007