=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215821616
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANUL FAMILY ALLIANCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2025
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1166 S ELMHURST RD
-----------------------------------------------------
City | MT PROSPECT
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60056-4241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-439-5195
-----------------------------------------------------
Fax | 847-439-5197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1166 S ELMHURST RD
-----------------------------------------------------
City | MT PROSPECT
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60056-4241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-616-2030
-----------------------------------------------------
Fax | 847-481-6990
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | IRENE J SOHN
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 773-478-8851
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------