Organization
JOHN C HENDRICKS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C HENDRICKS MD (PRESIDENT)
(309) 779-5000
Entity
Organization
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
PO BOX 689, LAKE FOREST, IL 60045-0689
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0990986
—
IA
Enumeration date
01/25/2007
Last updated
10/29/2007
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