Hendricks, Sean David
Hendricks, Sean David is an individual health care provider with primary practice located at 4800 Maine St , Quincy IL 62305-5875. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Hendricks, Sean David can be contacted via phone (217) 223-8400.Contact Information
Primary practice address
4800 Maine St
Quincy IL 62305-5875
Phone: (217) 223-8400
Fax: (217) 214-0455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 20248 | Mississippi |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 42382 | Tennessee |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 026330 | Louisiana |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 036147214 | Illinois |
Profile Details
| NPI number | 1164583084 |
|---|---|
| LBN Legal business name | Hendricks, Sean David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Nov 27th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164583084 | NPPES |
| Mississippi | Other | 302I182564 | MEDICARE PTAN |
| Mississippi | MEDICAID | 00226767 | MEDICARE PTAN |
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