HAWTHORN BEHAVIORAL HEALTH LLC NPI 1366768772

NPI Information

NPI: 1366768772
Provider Name: HAWTHORN BEHAVIORAL HEALTH LLC

Doing Business As: UZOMA OKOLI MD

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 14D2008104

Address:
30 TOWER CT STE C
GURNEE, IL
ZIP 60031
Phone: (847) 672-6478
Get Directions

HAWTHORN BEHAVIORAL HEALTH LLC is a mental health (including community mental health center) clinic center in Gurnee, IL. HAWTHORN BEHAVIORAL HEALTH LLC NPI is 1366768772. The provider is registered as an organization entity type.
The provider Is Doing Business As Uzoma Okoli Md.

The provider's business location address is:

30 TOWER CT STE C
GURNEE, IL
ZIP 60031-322
Phone: (847) 672-6478

The provider's authorized official is Uzoma Okoli .
The authorized official title is Owner and has the following contact phone number (847) 672-6478.

The CLIA number assigned to this NPI record is 14D2008104 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2010 and was last updated on 6/11/2019.

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
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

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

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