Provider First Line Business Practice Location Address:
CONDELL MEDICAL CENTER 2 E ROLLINS RD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
ROUND LAKE BEACH
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-740-2296
Provider Business Practice Location Address Fax Number:
847-740-0125
Provider Enumeration Date:
12/12/2006