John C Hendricks MD SC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

JOHN C HENDRICKS MD SC

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(309) 779-5000

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

John C Hendricks, MDNPI 1750381935

Title

President

Phone

(309) 779-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John C Hendricks, MD

  • Anesthesiology Physician
  • Rock Island, IL
  • NPI 1750381935

  IA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1225183437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C HENDRICKS MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-779-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0990986",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James a M Sales MD SC
• Jeffery M Jauron, DO
• Claire E Jeffers
• Jeffrey F Fullenkamp DO LTD
• Joanne a Michaelson MD
• Anitra Johnson, RN
• Dana Ellyn Johnson, DPT
• Quinn Cameron Johnson, RN
• Margaret Jones-Meersman, DPT
• Brandon Jones

• Anesthesiology Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.