Provider First Line Business Practice Location Address:
225 E CHICAGO AVE # 25
Provider Second Line Business Practice Location Address:
ANN AND ROBERT H LURIE CHILDREN'S HOSPITAL OF CHICAGO
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611-2991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-227-4000
Provider Business Practice Location Address Fax Number:
312-225-9414
Provider Enumeration Date:
01/11/2006