Provider First Line Business Practice Location Address:
1423 CHICAGO RD
Provider Second Line Business Practice Location Address:
ST. JAMES HOSPITAL
Provider Business Practice Location Address City Name:
CHICAGO HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60411-3400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-937-2239
Provider Business Practice Location Address Fax Number:
815-937-2062
Provider Enumeration Date:
03/28/2006