Provider Demographics
NPI:1982717674
Name:HAWTHORNE PSYCHIATRIC ASSOCIATES, SC
Entity type:Organization
Organization Name:HAWTHORNE PSYCHIATRIC ASSOCIATES, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SPELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-247-9300
Mailing Address - Street 1:850 N MILWAUKEE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1553
Mailing Address - Country:US
Mailing Address - Phone:847-247-9300
Mailing Address - Fax:847-247-9339
Practice Address - Street 1:850 N MILWAUKEE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1553
Practice Address - Country:US
Practice Address - Phone:847-247-9300
Practice Address - Fax:847-247-9339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103T00000X, 1041C0700X
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty