Provider First Line Business Practice Location Address:
BEVERLY MORGAN PARK MENTAL HEALTH CENTER
Provider Second Line Business Practice Location Address:
1987 W 111ST STREET
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-747-1100
Provider Business Practice Location Address Fax Number:
312-747-2782
Provider Enumeration Date:
08/15/2005