Provider First Line Business Practice Location Address:
500 COVENTRY LN; SUITE 170
Provider Second Line Business Practice Location Address:
CENTEGRA HEALTH SYSTEM: NEURO-REHABILITATION CENTER
Provider Business Practice Location Address City Name:
CRYSTAL LAKE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-356-2700
Provider Business Practice Location Address Fax Number:
815-356-2709
Provider Enumeration Date:
08/13/2012