Provider First Line Business Practice Location Address:
820 S. WOOD STREET
Provider Second Line Business Practice Location Address:
UNIVERSITY OF ILLINOIS CHICAGO DIVISION OF NEPHROLOGY M
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-6736
Provider Business Practice Location Address Fax Number:
312-996-7378
Provider Enumeration Date:
05/13/2024