Provider First Line Business Practice Location Address:
THOMAS JEFFERSON MIDDLE SCHOOL
Provider Second Line Business Practice Location Address:
600 S. LEWIS
Provider Business Practice Location Address City Name:
WAUKEGAN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
224-303-2560
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2019