Provider First Line Business Practice Location Address:
250 E SUPERIOR ST
Provider Second Line Business Practice Location Address:
NMH PRENTICE WOMEN'S HOSPITAL
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611-2914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-695-5753
Provider Business Practice Location Address Fax Number:
312-695-5645
Provider Enumeration Date:
12/23/2005