Provider First Line Business Practice Location Address:
225 E CHICAGO AVE # 70
Provider Second Line Business Practice Location Address:
ANN & ROBERT H. LURIES CHILDREN'S HOSPITAL OF CHICAGO
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-227-6180
Provider Business Practice Location Address Fax Number:
312-227-9411
Provider Enumeration Date:
06/04/2008