Individual
JESSICA HENDRIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1302 FRANKLIN AVE STE 2500, NORMAL, IL 61761
(309) 368-3240
(309) 268-3245
Mailing address
4400 W 95TH ST STE 308, OAK LAWN, IL 60453-2660
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-005908
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085005908
STATE LICENSE
IL
Enumeration date
11/05/2015
Last updated
06/22/2018
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