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Health Information Management 225 E. Chicago Ave, Box 11 Chicago, IL 60611 Phone: 312.227.5220 Fax: 312.227.9733(3279P)Medical Record No. Patient Name Birthdate Physician Please align patient label

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What is chicago ave box 11?

Chicago Avenue Box 11 is a box on the form where specific information related to Chicago Avenue must be reported.

Who is required to file chicago ave box 11?

Anyone conducting business on Chicago Avenue may be required to file information in Box 11 of the form.

How to fill out chicago ave box 11?

To fill out Chicago Ave Box 11, you will need to provide the required information about your business activities on Chicago Avenue.

What is the purpose of chicago ave box 11?

The purpose of Chicago Ave Box 11 is to gather data on business activities taking place on Chicago Avenue.

What information must be reported on chicago ave box 11?

You must report specific details about your business activities on Chicago Avenue, as required by the form.

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