Provider First Line Business Practice Location Address:
840 SOUTH WOOD STREET
Provider Second Line Business Practice Location Address:
PEDIATRIC GENETICS 12TH FLOOR M/C 856
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:
312-996-9283
Provider Business Practice Location Address Fax Number:
312-355-0739
Provider Enumeration Date:
02/19/2021