Provider First Line Business Practice Location Address: 
3701 DOTY RD
    Provider Second Line Business Practice Location Address: 
DEPARTMENT OF EMERGENCY MEDICAL SERVICES
    Provider Business Practice Location Address City Name: 
WOODSTOCK
    Provider Business Practice Location Address State Name: 
IL
    Provider Business Practice Location Address Postal Code: 
60098-7509
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
815-338-2500
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/24/2007