Provider Demographics
NPI:1750077160
Name:HANZIE, DAWN AURORA
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:AURORA
Last Name:HANZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3842
Mailing Address - Country:US
Mailing Address - Phone:708-382-0297
Mailing Address - Fax:
Practice Address - Street 1:1930 CORNELL DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-3842
Practice Address - Country:US
Practice Address - Phone:708-382-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018214101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional