Organization
HAWTHORNE PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY MATTSON (OWNER)
(847) 932-1079
Entity
Organization
Contact information
Practice address
977 LAKEVIEW PKWY, SUITE#103, VERNON HILLS, IL 60061-1400
(847) 932-1079
(847) 932-1082
Mailing address
977 LAKEVIEW PKWY, SUITE#103, VERNON HILLS, IL 60061-1400
(847) 932-1079
(847) 932-1082
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
042-617702
IL
Other
Enumeration date
06/24/2006
Last updated
01/25/2011
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