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Organization

ADVOCATE MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LORI OSBORNE PH.D. (COORDINATOR, MANAGER)
(773) 296-7688
Entity
Organization

Contact information

Practice address
3040 N WILTON AVE, 2ND FLOOR, CHICAGO, IL 60657-4424
(773) 296-5603
Mailing address
3040 N WILTON AVE, 2ND FLOOR, CHICAGO, IL 60657-4424

Taxonomy

Speciality
Code
Description
License number
State
283XC2000X
Children's Rehabilitation Hospital
Primary
071008251
IL

Other

Enumeration date
11/06/2012
Last updated
11/06/2012
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