Provider First Line Business Practice Location Address:
4001 W IRVING PARK RD
Provider Second Line Business Practice Location Address:
WALGREENS PHARMACY
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60641-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-675-4724
Provider Business Practice Location Address Fax Number:
847-675-4554
Provider Enumeration Date:
08/26/2011