Provider First Line Business Practice Location Address:
225 EAST CHICAGO AVENUE BOX 107
Provider Second Line Business Practice Location Address:
DIVISION OF DERMATOLOGY
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-227-6060
Provider Business Practice Location Address Fax Number:
312-227-9402
Provider Enumeration Date:
04/15/2025