Provider First Line Business Practice Location Address:
2751 W WINONA ST
Provider Second Line Business Practice Location Address:
SWEDISH COVENANT HOSPITAL
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60625-2508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-878-8200
Provider Business Practice Location Address Fax Number:
773-907-3032
Provider Enumeration Date:
11/09/2006