Individual
JULIAN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 W COURT ST STE 214, KANKAKEE, IL 60901-3674
(815) 928-6131
Mailing address
555 W COURT ST STE 214, KANKAKEE, IL 60901-3674
(815) 928-6131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036165552
IL
208600000X
Surgery Physician
LP04240
RI
2086S0102X
Surgical Critical Care Physician
036165552
IL
Other
Enumeration date
05/22/2018
Last updated
09/09/2024
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