Provider First Line Business Practice Location Address:
3600 W FULLERTON
Provider Second Line Business Practice Location Address:
INFANT WELFARE SOCIETY OF CHICAGO CLINIC
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60647-2319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-782-2800
Provider Business Practice Location Address Fax Number:
773-782-5042
Provider Enumeration Date:
09/16/2006