Provider First Line Business Practice Location Address: 
1740 W. TAYLOR ST. , 3200W
    Provider Second Line Business Practice Location Address: 
UIC PHYSICIANS BILLING GROUP
    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: 
312-996-4020
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
04/07/2014