Provider Demographics
NPI:1588611057
Name:HENDRIX, ANDREW L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 BEISNER RD STE 1500
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3475
Mailing Address - Country:US
Mailing Address - Phone:847-631-5664
Mailing Address - Fax:847-631-5663
Practice Address - Street 1:955 BEISNER RD STE 1509
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3475
Practice Address - Country:US
Practice Address - Phone:847-631-5664
Practice Address - Fax:847-631-5663
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097375208100000X
IL0360973752081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097375-1Medicaid
INP00974281OtherRAILROAD MEDICARE
IL250011896OtherRAILROAD MEDICARE
IL036097375-1Medicaid
IL036097375-2Medicaid
IL036097375-1Medicaid
ILH02808Medicare UPIN
IN259780CMedicare PIN
INP00974281OtherRAILROAD MEDICARE
ILL76486Medicare PIN