Provider First Line Business Practice Location Address:
UNIVERSITY OF ILLINOIS EYE AND EAR INFIRMARY
Provider Second Line Business Practice Location Address:
1855 WEST TAYLOR STREET, M/C 648 ROOM 3.138
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:
312-413-3593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2011