Provider First Line Business Practice Location Address:
3245 S GROVE AVE
Provider Second Line Business Practice Location Address:
STE #101/102 MERCADO FOOT AND ANKLE CLINICS
Provider Business Practice Location Address City Name:
BERWYN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-484-3599
Provider Business Practice Location Address Fax Number:
708-749-0727
Provider Enumeration Date:
09/16/2006