Provider Demographics
NPI:1821397472
Name:HAWTHORN WOODS FAMILY EYE CARE INC.
Entity Type:Organization
Organization Name:HAWTHORN WOODS FAMILY EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNIESZKA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRYJECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-960-4749
Mailing Address - Street 1:60 LANDOVER PKWY
Mailing Address - Street 2:UNIT B1
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7513
Mailing Address - Country:US
Mailing Address - Phone:773-960-4749
Mailing Address - Fax:847-847-2210
Practice Address - Street 1:60 LANDOVER PKWY
Practice Address - Street 2:UNIT B1
Practice Address - City:HAWTHORN WOODS
Practice Address - State:IL
Practice Address - Zip Code:60047-7513
Practice Address - Country:US
Practice Address - Phone:773-960-4749
Practice Address - Fax:847-847-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04900820001156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty