Provider Demographics
NPI:1851665996
Name:MATTHEW S HENDRICKSON, OD & ASSOCIATES PC
Entity Type:Organization
Organization Name:MATTHEW S HENDRICKSON, OD & ASSOCIATES PC
Other - Org Name:CLARITY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:HENDRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-474-4487
Mailing Address - Street 1:837 WESTMORE MEYERS RD STE A24
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6516
Mailing Address - Country:US
Mailing Address - Phone:630-474-4487
Mailing Address - Fax:630-487-5109
Practice Address - Street 1:837 WESTMORE MEYERS RD STE A24
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6516
Practice Address - Country:US
Practice Address - Phone:630-474-4487
Practice Address - Fax:630-487-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010209152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty