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HAWTHORNE PHYSICAL MEDICINE NPI 1336175801


NPI Information

NPI: 1336175801
Provider Name: HAWTHORNE PHYSICAL MEDICINE
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
977 LAKEVIEW PKWY
SUITE#103
VERNON HILLS, IL
ZIP 60061
Phone: (847) 932-1079
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HAWTHORNE PHYSICAL MEDICINE is a preferred provider organization in Vernon Hills, IL. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. HAWTHORNE PHYSICAL MEDICINE NPI is 1336175801. The provider is registered as an organization entity type.

The provider's business location address is:

977 LAKEVIEW PKWY
SUITE#103
VERNON HILLS, IL
ZIP 60061-400
Phone: (847) 932-1079
Fax: (847) 932-1082

The provider's authorized official is Bradley Mattson .
The authorized official title is Owner and has the following contact phone number (847) 932-1079.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 1/25/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305R00000XPreferred Provider Organization042-617702ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1207664MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.