Provider First Line Business Practice Location Address:
3059 W. 26TH ST.
Provider Second Line Business Practice Location Address:
SAH DIALYSIS CLINIC
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60623-4131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-696-9470
Provider Business Practice Location Address Fax Number:
773-376-3811
Provider Enumeration Date:
06/18/2013