Provider First Line Business Practice Location Address:
2542 W NORTH AVE
Provider Second Line Business Practice Location Address:
C/O COMMUNITY COUNSELING CENTERS OF CHICAGO
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60647-5216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-365-3047
Provider Business Practice Location Address Fax Number:
773-365-3093
Provider Enumeration Date:
07/28/2006