Provider First Line Business Practice Location Address:
3333 GREEN BAY RD
Provider Second Line Business Practice Location Address:
DEPT. OF PSYCHIATRY
Provider Business Practice Location Address City Name:
NORTH CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60064-3037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-578-8719
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2008