Provider First Line Business Practice Location Address:
THE CHICAGO LIGHTHOUSE,
Provider Second Line Business Practice Location Address:
1850 W. ROOSEVELT RD.
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-666-1331
Provider Business Practice Location Address Fax Number:
312-596-0103
Provider Enumeration Date:
04/03/2007