Provider First Line Business Practice Location Address:
1740 W. TAYLOR ST, RM2483
Provider Second Line Business Practice Location Address:
DEPT RADIOLOGY MC 931
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-355-2857
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2006