Provider First Line Business Practice Location Address:
UI HOSPITAL
Provider Second Line Business Practice Location Address:
1740 W. TAYLOR STREET, M/C 931
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-6061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-0241
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2008