Provider First Line Business Practice Location Address:
845 S. DAMEN AVE.
Provider Second Line Business Practice Location Address:
PMA DEPT. SUITE 1008 UIC COLLEGE OF NURSING (MC802)
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-7350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-7972
Provider Business Practice Location Address Fax Number:
312-996-9049
Provider Enumeration Date:
08/08/2006