Provider First Line Business Practice Location Address:
EDWARD HINES VA HOSPITAL
Provider Second Line Business Practice Location Address:
MENTAL HEALTH SERVICE LINE - BLG 228
Provider Business Practice Location Address City Name:
HINES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-202-7817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006