Organization
BEVERLY HENDERSON LTD P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEVERLY HENDERSON (PRESIDENT)
(312) 791-0453
Entity
Organization
Contact information
Practice address
2807 S ARCHER AVE, CHICAGO, IL 60608-5617
(312) 791-0453
(312) 791-0715
Mailing address
2807 S ARCHER AVE, CHICAGO, IL 60608-5617
(312) 791-0453
(312) 791-0715
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1605885
BCBS
IL
Enumeration date
08/13/2007
Last updated
10/10/2007
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