Healthcare Provider Details

I. General information

NPI: 1891607594
Provider Name (Legal Business Name): HAWK PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15040 S RAVINIA AVE STE 43
ORLAND PARK IL
60462-3173
US

IV. Provider business mailing address

15040 S RAVINIA AVE STE 43
ORLAND PARK IL
60462-3173
US

V. Phone/Fax

Practice location:
  • Phone: 708-465-7752
  • Fax: 708-503-1095
Mailing address:
  • Phone: 708-465-7752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: PHILLIP GREGORY HAWK
Title or Position: OWNER
Credential: LCPC, BCBA
Phone: 708-465-7752