Basic Information
| Provider Information | |||||||||
| NPI: | 1245581867 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | ALETA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27555 DIEHL RD | ||||||||
| Address2: | ENTRANCE B | ||||||||
| City: | WARRENVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605553849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306463950 | ||||||||
| FaxNumber: | 6305486832 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 S WEBER RD | ||||||||
| Address2: | |||||||||
| City: | ROMEOVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604464947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305273645 | ||||||||
| FaxNumber: | 8152932902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2012 | ||||||||
| LastUpdateDate: | 11/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 085004434 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.