Healthcare Provider Details

I. General information

NPI: 1730151168
Provider Name (Legal Business Name): HAWTHORN PLACE OUTPATIENT SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 CENTER DR
VERNON HILLS IL
60061-1518
US

IV. Provider business mailing address

240 CENTER DR
VERNON HILLS IL
60061-1518
US

V. Phone/Fax

Practice location:
  • Phone: 847-367-8100
  • Fax:
Mailing address:
  • Phone: 847-367-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL WADKINS
Title or Position: MANAGER OF OPERATIONS
Credential:
Phone: 847-367-8100