Provider First Line Business Practice Location Address:
1240 S DAMEN AVE
Provider Second Line Business Practice Location Address:
CHICAGO CHILDREN'S ADVOCACY CENTER MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60608-1122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-492-3862
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2006