Provider Demographics
NPI:1770632689
Name:HORIZON GAWO LTD.
Entity Type:Organization
Organization Name:HORIZON GAWO LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:YACOB
Authorized Official - Middle Name:H
Authorized Official - Last Name:GAWO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-736-4444
Mailing Address - Street 1:4403 W LAWRENCE AVE
Mailing Address - Street 2:STE # 209
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2513
Mailing Address - Country:US
Mailing Address - Phone:773-736-4444
Mailing Address - Fax:773-283-4849
Practice Address - Street 1:4403 W LAWRENCE AVE
Practice Address - Street 2:STE # 209
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2513
Practice Address - Country:US
Practice Address - Phone:773-736-4444
Practice Address - Fax:773-283-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC48880Medicare UPIN