Phone Number: 773-777-1111
Mon: 9:00am – 6:00pm
Tue: 9:00am – 5:00pm
Wed: 9:00am – 6:00pm
Thu: 9:00am – 5:00pm
Fri: 9:00am – 6:00pm
Phone Number: 414-276-4262
Mon: 8:00am – 5:00pm
Tue: 8:00am – 5:00pm
Wed: 8:00am – 5:00pm
Thu: 8:00am – 5:00pm
Fri: 8:00am – 12:00pm
I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.
