Provider First Line Business Practice Location Address:
610 N. LINCOLN AVE.
Provider Second Line Business Practice Location Address:
NEUROSURGERY
Provider Business Practice Location Address City Name:
URBANA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61801-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-383-3507
Provider Business Practice Location Address Fax Number:
217-383-3171
Provider Enumeration Date:
08/30/2012