Individual provider Active NPI

Sonya D Hawthorne, DT

  • Developmental Therapist
  • Matteson, IL
National Provider Identifier
1104033596
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
SH77250900P Issued in IL
Practice address
21141 Governors Hwy
PMB 1073 Suite 114
Matteson, IL 60443-3818
Phone
(708) 218-1863
Fax
(708) 418-3913
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X SH77250900P IL Primary

Addresses

Primary practice location

21141 Governors Hwy
PMB 1073 Suite 114
Matteson, IL 60443-3818

Mailing address

21141 Governors Hwy
PMB 1073 Suite 114
Matteson, IL 60443-3818
Phone (708) 218-1863

Other identifiers 1

IdentifierTypeStateIssuer
364457327OtherILDT CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SH77250900PILMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawthorne Developmental Agency CurrentSince Aug 2, 2020 Accepting new patients

Locations

21141 Governors Hwy
Ste 114
Matteson, IL 60443
Phone (708) 218-1863

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1104033596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21141 GOVERNORS HWY",
            "address_2": "PMB 1073 SUITE 114",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433818",
            "telephone_number": "708-218-1863",
            "fax_number": "708-418-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21141 GOVERNORS HWY",
            "address_2": "PMB 1073 SUITE 114",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433818",
            "telephone_number": "708-218-1863",
            "fax_number": "708-418-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "SONYA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "DT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "IL",
            "license": "SH77250900P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DT CERTIFICATION",
            "identifier": "364457327",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.