Provider First Line Business Practice Location Address:
2300 CHILDRENS PLAZA
Provider Second Line Business Practice Location Address:
CHILDRENS MEMORIAL HOSPITAL DIR OF PEDS EMERG MED
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-880-3884
Provider Business Practice Location Address Fax Number:
773-880-3884
Provider Enumeration Date:
03/24/2006