Provider Demographics
NPI:1659485019
Name:HAWK, CAROLINE KING (PHD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:KING
Last Name:HAWK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:HINES VA HOSPIAL, SCI CENTER BUILDING 128
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141-5000
Mailing Address - Country:US
Mailing Address - Phone:708-202-3994
Mailing Address - Fax:708-202-7960
Practice Address - Street 1:1 FIFTH AVENUE & ROOSEVELT ROAD
Practice Address - Street 2:HINES VA HOSPITAL, SCI CENTER BUILDING 128
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-3994
Practice Address - Fax:708-202-7960
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical