Provider First Line Business Practice Location Address:
225 EAST CHICAGO AVE, BOX 152
Provider Second Line Business Practice Location Address:
ANN & ROBERT H. LURIE 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:
312-227-7413
Provider Business Practice Location Address Fax Number:
312-227-9525
Provider Enumeration Date:
10/20/2005