Provider First Line Business Practice Location Address:
1901 W HARRISON ST DEPT NEUROSURGE
Provider Second Line Business Practice Location Address:
JOHN H STROGERER HOSPITAL - SUITE 643
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-3714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-864-5120
Provider Business Practice Location Address Fax Number:
312-864-9606
Provider Enumeration Date:
09/13/2006