Provider First Line Business Practice Location Address:
912 SOUTH WOOD STREET UIC NEUROLOGY RESIDENCY
Provider Second Line Business Practice Location Address:
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:
312-996-6906
Provider Business Practice Location Address Fax Number:
312-996-4169
Provider Enumeration Date:
05/07/2020